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[自我毁灭的精神病理学与心理动力学]

[Psychopathology and psychodynamics of self destruction].

作者信息

Pöldinger W J, Holsboer-Trachsler E

出版信息

Schweiz Rundsch Med Prax. 1989 Feb 28;78(9):214-8.

PMID:2928618
Abstract

Starting from the first publications on the topic as e.g. the famous monograph "Le suicide" written by Durkheim in 1897, the suicide research was based mainly on psychosocial dimensions. Therefore, the main area of research were patients who had survived an attempt of suicide. This led to the faulty conclusion that these patients represent the largest risk group. Today we know that depressive patients represent the number one risk group. They are followed by drug and alcohol addicts, by elderly and lonesome people, by the group of patients who threaten with suicide or who announce it, and finally as a last risk group, by those people who have failed at a first attempt. The psychodynamics show that suicidal behavior is akin to self-aggression. Mainly among younger people occur suicides, which have predominantly the function to appeal, to draw attention to the subject who has been unable to verbalize his problems. One attempt to help these people consists of becoming aware that the wish to die generally goes along with the wish to stay alive, from which result the cries for help and announcements of suicide. Apart from this psychosocial suicide research, in recent years a biological component turned out to be possibly more relevant than originally assumed. With respect to the heredity of suicidal behavior up to now only those suicidal acts were considered that occur within the frame of endogenous depressions. Recent studies however point at an accumulation within families that is not in context with the manic-depressive illness. Biochemical studies indicate in addition that suicidal behavior tends to go along frequently with a lack of serotonin. From this follows that inthe future suicide and suicide treatment will see a biopsychosocial theory as a basis.

摘要

从关于该主题的首批出版物开始,比如涂尔干在1897年撰写的著名专著《自杀论》,自杀研究主要基于社会心理层面。因此,主要的研究领域是自杀未遂后幸存的患者。这导致了一个错误的结论,即这些患者代表了最大的风险群体。如今我们知道,抑郁症患者是头号风险群体。其次是吸毒和酗酒成瘾者、老年人和孤独的人、威胁或宣称要自杀的患者群体,最后作为最后一个风险群体,是那些首次自杀未遂的人。心理动力学表明,自杀行为类似于自我攻击。自杀主要发生在年轻人中,其主要作用是引起关注,让那些无法表达自己问题的人得到关注。帮助这些人的一种尝试是意识到想死的愿望通常与想活下去的愿望相伴而生,由此产生了求助呼声和自杀宣称。除了这种社会心理层面的自杀研究,近年来发现生物学因素可能比最初设想的更相关。关于自杀行为的遗传,到目前为止只考虑了那些发生在内源性抑郁症范围内的自杀行为。然而,最近的研究指出,家庭内部存在一种与躁郁症无关的自杀行为聚集现象。生化研究还表明,自杀行为往往经常伴随着血清素缺乏。由此可见,未来自杀及自杀治疗将以生物心理社会理论为基础。

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