Wolfersdorf M, Vogel R, Vogl R, Grebner M, Keller F, Purucker M, Wurst F M
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Bayreuth, Akademisches Lehrkrankenhaus der Universität Erlangen-Nürnberg, Nordring 2, 95445, Bayreuth, Deutschland.
Klinik für Forensische Psychiatrie und Psychotherapie, Abteilung Psychiatrie II der Universität Ulm, Bezirkskrankenhaus Günzburg, Günzburg, Deutschland.
Nervenarzt. 2016 May;87(5):474-82. doi: 10.1007/s00115-016-0111-3.
Suicide prevention is a core responsibility of psychiatry and psychotherapy. Periods of change in psychiatric inpatient treatment concepts are usually also accompanied by an increase in psychopathological behavior and with increased suicide rates in psychiatric hospitals, as seen in the 1970s and 1980s in Germany. That this represented a real increase of inpatient suicides during those years was confirmed and subsequently the number and rate of inpatient suicides has decreased from approximately 280 out of 100,000 admissions of patients in 1980 to approximately 50 in 2014. Death can also occur in psychiatric hospitals and an absolute prevention is not possible even under optimal conditions of therapy and nursing, communication and security. The suicide rate has clearly decreased over the last two decades in relation to admissions. The group of young male schizophrenic patients newly identified as having a high clinical suicide risk has decreased among the suicide victims whereas the percentage of severely depressed patients with delusions has increased. This reduction could be associated with the comprehensive improvements in educational and training programs in the field of suicide and suicide prevention, objectification of coping methods, development of diagnostic and therapeutic strategies, improvements in therapy and relationship possibilities and a general reduction in the number of suicides in Germany.
预防自杀是精神病学和心理治疗的核心职责。精神病住院治疗理念发生转变的时期，通常也伴随着精神病理行为的增加以及精神病医院自杀率的上升，比如20世纪70年代和80年代的德国。事实证明，那些年住院患者自杀率确实有所上升，随后住院患者自杀数量和比率从1980年每10万例入院患者中约280例降至2014年的约50例。死亡也可能发生在精神病医院，即使在治疗、护理、沟通和安全的最佳条件下，也不可能做到绝对预防。过去二十年来，相对于入院人数，自杀率明显下降。新认定具有高临床自杀风险的年轻男性精神分裂症患者在自杀受害者中的比例有所下降，而伴有妄想的重度抑郁症患者的比例有所上升。这种下降可能与自杀及自杀预防领域教育和培训项目的全面改进、应对方法的客观化、诊断和治疗策略的发展、治疗及医患关系可能性的改善以及德国自杀总数的普遍减少有关。
