Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary.
Int J Psychiatry Clin Pract. 2010 Jun;14(2):88-94. doi: 10.3109/13651501003624712.
Abstract Suicide attempt, and particularly completed suicide are relatively rare events in the community, but they are very common among psychiatric patients. Since over 90% of suicide victims suffer from (mostly untreated) current major mental disorders (particularly from major depressive episode), psychiatric risk factors are the clinically most useful predictors, especially if psychosocial and demographic risk factors are also pesent. Violent behaviours associated with mood disorders constitute a related yet independently also important aspect of this illness, and assessment and management of violence is a key component of everyday psychiatric practice. While most people with current mental disorder are not violent, violence is more common among seriously mentally ill individuals than in healthy persons. This is particularly true for untreated schizophrenics and untreated patients with major mood disorders, first of all in the cases of comorbid substance use disorders, mainly among those with current mania or postpartum depression. Although specific clinical studies are lacking, it is very lilely that successful acute and long-tem treatment of mood disorders can reduce the risk of violent behaviour in this patient population.
摘要
自杀未遂，尤其是完成自杀，在社区中是相对罕见的事件，但在精神科患者中却非常常见。由于 90%以上的自杀者患有（主要是未经治疗的）当前的主要精神障碍（特别是重性抑郁发作），因此精神科风险因素是临床上最有用的预测因素，特别是如果存在心理社会和人口统计学风险因素的话。与心境障碍相关的暴力行为是该疾病的一个相关但独立的重要方面，评估和管理暴力是日常精神科实践的关键组成部分。虽然大多数当前患有精神障碍的人不会表现出暴力行为，但在严重精神疾病患者中，暴力行为比在健康人群中更为常见。对于未经治疗的精神分裂症患者和未经治疗的主要心境障碍患者来说尤其如此，特别是在合并物质使用障碍的情况下，主要是在当前有躁狂或产后抑郁的患者中。尽管缺乏具体的临床研究，但很可能成功的急性和长期心境障碍治疗可以降低该患者群体发生暴力行为的风险。
