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[精神分裂症性精神病中的自杀倾向:当前概述]

[Suicidality in schizophrenic psychosis: a current overview].

作者信息

Knorr Roman, Hoffmann Klaus

机构信息

Klinik für Sozialpsychiatrie, ZfP Reichenau, Feursteinstr. 55, 78479, Reichenau, Deutschland.

Klinik für Forensische Psychiatrie und Psychotherapie, ZfP Reichenau, Feursteinstr. 55, 78479, Reichenau, Deutschland.

出版信息

Nervenarzt. 2021 Nov;92(11):1186-1195. doi: 10.1007/s00115-020-01028-2. Epub 2020 Nov 9.

Abstract

BACKGROUND

Suicidality in schizophrenic psychosis is an important topic but stands in clinical everyday work behind the perception of suicide especially in affective disorders. Schizophrenic psychosis is recognized as an independent risk factor for suicide attempts and suicides, whereas it poses particular challenges to the clinical professional due to the frequent unpredictability, abruptness and brutality of the methods used. For this reason, the suicide of a psychotic patient often leaves the professional and non-professional environment disturbed.

AIMS

An overview of the existing relevant literature on suicide in psychosis is given. Explanations on the psychodynamics, indications on pharmacotherapy and psychotherapy and considerations on prevention round off this article and provide an up to date overview of this topic for clinicians.

MATERIAL AND METHODS

A search was carried out in PubMed and Google scholar using the terms "suicide", "suicidality", "schizophrenia", "suicide AND schizophrenia", "suicide AND psychosis", "suicidality AND schizophrenia", "suicidality AND psychosis", "suicidality AND psychosis AND prevention", "suicide AND psychosis AND prevention", "suicidality AND schizophrenia AND prevention", "suicide AND schizophrenia AND prevention".

CONCLUSION

Clinicians must have knowledge of the specific risk factors for suicide in psychotic patients, the characteristics of suicide in terms of design and temporal connection with treatment. The exploration and assessment of suicidality is often more difficult in psychotic patients than in affective or personality disorder patients, as there are often impulsive suicide attempts that can be explained by (suddenly occurring) psychotic symptoms and are therefore difficult or even impossible to foresee.

摘要

背景

精神分裂症性精神病中的自杀倾向是一个重要话题,但在日常临床工作中,相较于自杀观念,它受到的关注较少,尤其是在情感障碍方面。精神分裂症性精神病被认为是自杀未遂和自杀的独立危险因素,然而,由于自杀方式常常具有不可预测性、突发性和残忍性,这给临床专业人员带来了特殊挑战。因此,精神病患者的自杀往往会使专业和非专业环境都受到困扰。

目的

对现有的关于精神病患者自杀的相关文献进行综述。本文还对心理动力学进行了解释,给出了药物治疗和心理治疗的指征,并探讨了预防措施,为临床医生提供了该主题的最新概述。

材料与方法

在PubMed和谷歌学术上进行检索,检索词包括“自杀”“自杀倾向”“精神分裂症”“自杀与精神分裂症”“自杀与精神病”“自杀倾向与精神分裂症”“自杀倾向与精神病”“自杀倾向与精神病与预防”“自杀与精神病与预防”“自杀倾向与精神分裂症与预防”“自杀与精神分裂症与预防”。

结论

临床医生必须了解精神病患者自杀的特定危险因素、自杀在设计方面的特点以及与治疗的时间关联。对自杀倾向的探究和评估在精神病患者中往往比在情感障碍或人格障碍患者中更困难,因为经常会有冲动性自杀企图,这些企图可由(突然出现的)精神病症状解释,因此难以甚至无法预见。

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