Steele Ian H, Thrower Natasha, Noroian Paul, Saleh Fabian M
Harvard Longwood Psychiatry Resident Training Program Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Ave, Rabb-2, Boston, MA 02215.
Harvard Longwood Psychiatry Resident Training Program Brigham and Women's Hospital, Department of Psychiatry 221 Longwood Ave, Boston, MA 02115.
J Forensic Sci. 2018 Jan;63(1):162-171. doi: 10.1111/1556-4029.13519. Epub 2017 Jun 21.
Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety.
自杀是一种令人不安但可预防的现象。在自杀未遂之前,个体通常会寻求帮助,这促使从业者进行风险评估,理想情况下应采用基于证据的风险管理策略。我们使用哈佛康威医学图书馆、谷歌学术、PubMed进行了文献综述。使用的关键词有“法医学”“自杀风险管理”“青少年自杀风险因素”“成人自杀风险因素”“老年自杀风险因素”“自杀风险评估”。参数将文章限制为过去二十年在美国完成的研究/综述。结果表明,青少年自杀的预测因素是失眠、觉得自己是他人的负担以及近期与家人或恋爱伴侣发生冲突。成年男性、滥用药物者、婚姻/工作失者自杀风险更高。患有多种内科合并症、感到绝望和孤立的老年人自杀风险更高。对每个接受评估的人都应筛查其是否有机会接触枪支。自杀风险的管理包括提供限制最小的治疗形式,以确保个体安全。