Departement of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland; Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
Acta Biomed. 2020 Nov 10;91(4):e2020163. doi: 10.23750/abm.v91i4.10515.
Consequences on mental health have been reported in general population, vulnerable individuals, psychiatric patients, and healthcare professionals. It is urgently necessary to study mental health issues in order to set priorities for public health policies and implement effective interventions. Suicidality is one of the most extreme outcomes of a mental health crisis. It is currently too early to know what the effect of COVID-19 will be on suicidality. However, authoritative commentary papers alert that most of the factors precipitating suicide are, and probably will be for a long time, present at several individual existence levels. A number of prevention measures and research considerations have been drawn up. A point of the latter, recommended by the International COVID-10 Suicide Prevention Research Collaboration, states that "the COVID-19 suicide research response should be truly multidisciplinary. This will foster research that addresses the different aspects and layers of risk and resilience.It will also foster research that informs prevention efforts by taking a range of perspectives" (Niederkrotenthaler et al., 2020). In this light, we would like to propose a reading perspective of suicidality that takes into account Meaning in Life (MiL) and demoralization. Both of the constructs were studied in heterogeneous populations with extreme life situations having led to a fracture between a "before" and an "after", and play a role in affecting suicidality, respectively as resilience and risk factors. In clinical practice, during these unprecedent times, we wish that this more inclusive approach could: 1) contribute to prevention, by delineating more individualized suicidal risk profiles in persons conventionally non-considered at risk but here exposed to an extremely uncommon experience, 2) enrich supportive/psychotherapeutic interventions, by broadening the panel of means to some aspects constitutive of the existential condition of a person who is brutally confronted with something unexpected, incomprehensible and, in some ways, still unpredictable.
心理健康的后果已在普通人群、弱势群体、精神疾病患者和医疗保健专业人员中报告。为了确定公共卫生政策的优先事项并实施有效的干预措施，迫切需要研究心理健康问题。自杀是精神健康危机的最极端后果之一。目前还为时过早，无法知道 COVID-19 对自杀的影响。然而，权威评论文章提醒说，大多数导致自杀的因素现在存在，并且可能在很长一段时间内存在于几个个体存在层面上。已经制定了一些预防措施和研究考虑因素。后者的一个要点是由国际 COVID-19 自杀预防研究合作组织建议的，指出“COVID-19 自杀研究应对措施应该真正是多学科的。这将促进研究解决风险和复原力的不同方面和层面。它还将促进研究，通过采取一系列观点，为预防工作提供信息”（Niederkrotenthaler 等人，2020 年）。有鉴于此，我们想提出一种考虑生活意义（MiL）和道德低落的自杀倾向阅读视角。这两个结构都在经历过导致“以前”和“以后”之间出现断裂的极端生活情况的异质人群中进行了研究，分别作为复原力和风险因素在影响自杀倾向方面发挥作用。在临床实践中，在这些前所未有的时期，我们希望这种更具包容性的方法可以：1）通过描绘通常不被认为有风险但现在暴露于极不寻常经历的人的更个体化自杀风险特征，有助于预防，2）通过拓宽一些方面的手段，丰富支持/心理治疗干预措施，这些方面构成了一个人突然面临意想不到、无法理解和在某些方面仍然不可预测的事物的存在状况。
