Beyer John L, Weisler Richard H
Duke University Medical Center, Box 3519, Durham, NC 27710, USA.
Duke University Medical Center, Box 3519, Durham, NC 27710, USA.
Psychiatr Clin North Am. 2016 Mar;39(1):111-23. doi: 10.1016/j.psc.2015.09.002. Epub 2015 Dec 22.
Suicide behaviors (ideation, attempts, and completions) are unfortunately common in patients with bipolar disorder. It is estimated that 25 to 50% attempt suicide at least once during their lifetime, and 6% to 19% complete suicide. Risk factors include a family history of suicide, previous suicide attempts, younger age of onset, comorbid psychiatric illnesses, and psychological constructs like hopelessness. Pharmacologic treatment may impact suicidal behaviors, either increasing vulnerability or resilience. Clinicians need to be particularly sensitive to their patient's thoughts and beliefs about death, particularly during stressful times of life or when in a depressive/mixed episode of bipolar disorder.
不幸的是，自杀行为（自杀意念、自杀未遂和自杀死亡）在双相情感障碍患者中很常见。据估计，25%至50%的患者一生中至少有过一次自杀未遂，6%至19%的患者自杀死亡。风险因素包括自杀家族史、既往自杀未遂史、发病年龄较轻、合并精神疾病以及绝望等心理因素。药物治疗可能会影响自杀行为，要么增加自杀易感性，要么增强心理韧性。临床医生需要特别关注患者对死亡的想法和信念，尤其是在生活压力较大的时候，或者处于双相情感障碍的抑郁/混合发作期。
