Department of Pediatrics, Children's Hospital at Dartmouth-Hitchcock.
Department of Psychiatry, Section of Child and Adolescent Psychiatry.
Curr Opin Pediatr. 2020 Aug;32(4):595-600. doi: 10.1097/MOP.0000000000000916.
Suicide is a major public health concern and the second leading cause of death for adolescents. Faced with an already-high prevalence and increasing rates over the past decade, pediatricians feel inadequately prepared to manage a suicidal patient. This article will review the changing rates of suicide, discuss recent literature on risk factors, identify methods to screen for suicidal thoughts and suggest an approach to counseling a suicidal patient. Finally, there will be a brief discussion on safety planning and public health measures to help reduce suicide rates.
Rates of attempted suicide and death by suicide have been increasing for more than a decade. Risk assessment of potential suicidality remains very challenging, as the risk factors are multifactorial. However, some common risk factors persist including sexual minority identification and family or personal history of mental health issues. Although keeping these and other risk factors in mind, regular screening of adolescents for depression and self-harm is important. Finally, the best safety plans and treatment methods appear to be team-based.
It remains the responsibility of pediatricians to stay aware of risk factors, regularly screen adolescents and prioritize collaborative safety planning for suicidal patients.
自杀是一个主要的公共卫生关注点，也是青少年的第二大死因。面对已经很高的发病率和过去十年中不断上升的自杀率，儿科医生感到自己在处理自杀患者方面准备不足。本文将回顾自杀率的变化，讨论最近关于风险因素的文献，确定筛查自杀想法的方法，并提出咨询自杀患者的方法。最后，将简要讨论安全计划和公共卫生措施，以帮助降低自杀率。
自杀未遂和自杀死亡的比率在过去十年中一直在上升。对潜在自杀可能性的风险评估仍然极具挑战性，因为风险因素是多方面的。然而，一些常见的风险因素仍然存在，包括性少数群体认同和家庭或个人精神健康问题史。尽管要记住这些和其他风险因素，但定期筛查青少年的抑郁和自残行为很重要。最后，最好的安全计划和治疗方法似乎是基于团队的。
儿科医生有责任始终了解风险因素，定期筛查青少年，并优先为有自杀风险的患者进行协作安全计划。
