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身体痛苦与人际关系问题:探索老年自杀患者的心理社会及内心世界

Physical distress and relationship problems: exploring the psychosocial and intrapsychic world of suicidal geriatric patients.

作者信息

Lindner R, Foerster R, von Renteln-Kruse W

机构信息

Medizinisch-Geriatrische Klinik, Albertinen-Haus, Zentrum für Geriatrie und Gerontologie, Wissenschaftliche Einrichtung der Universität Hamburg, Sellhopsweg 18-22, 20257, Hamburg, Germany,

出版信息

Z Gerontol Geriatr. 2014 Aug;47(6):502-7. doi: 10.1007/s00391-013-0563-z.

Abstract

BACKGROUND

Suicide is a serious mental health problem in old age. Suicide ideation and life weariness are important psychopathological issues in geriatric medicine, although suicide ideation does not primarily depend on the severity of any physical disease. Despite these facts, insight into the internal psychological state of suicidal geriatric patients is still limited.

MATERIAL AND METHODS

This study examines intrapsychic and psychosocial issues in suicidal geriatric inpatients. A semistructured interview concerning suicide ideation in old age was used to interview 20 randomly chosen, acutely suicidal clinically geriatric inpatients aged 60 years and older. The control group comprised 20 nonsuicidal patients.

RESULTS

Hamilton Depression Scale 21 scores (HAMD 21; patient mean 17.3, control mean 6.1), suicidal ideation and psychiatric treatments differed significantly between the groups. In contrast to lifetime suicidal ideation, the discovery of a physical disease was the primary trigger for current suicidal ideation, followed by interactional conflicts. Patients would rather speak with family or friends than professionals about their suicidal ideation.

CONCLUSION

Suicidal ideation should be recognised as an important psychological problem in geriatric patients with interpersonal conflicts. Specific help and training for relatives is recommended.

摘要

背景

自杀是老年人群中一个严重的心理健康问题。自杀观念和生活倦怠是老年医学中的重要精神病理学问题,尽管自杀观念并不主要取决于任何躯体疾病的严重程度。尽管如此,对有自杀倾向的老年患者内心心理状态的了解仍然有限。

材料与方法

本研究探讨老年自杀住院患者的内心及社会心理问题。采用一份关于老年自杀观念的半结构式访谈,对随机选取的20名60岁及以上有急性自杀倾向的临床老年住院患者进行访谈。对照组包括20名无自杀倾向的患者。

结果

两组间汉密尔顿抑郁量表21项评分(HAMD 21;患者组均值为17.3,对照组均值为6.1)、自杀观念及精神治疗存在显著差异。与终生自杀观念不同,发现躯体疾病是当前自杀观念的主要触发因素,其次是人际冲突。患者更愿意与家人或朋友而非专业人员谈论他们的自杀观念。

结论

自杀观念应被视为人际冲突的老年患者中的一个重要心理问题。建议为亲属提供特定的帮助和培训。

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