Litman R E
Calif Med. 1966 Mar;104(3):168-74.
Suicidal crises are best understood as late stages in the progressive breakdown of adaptational behavior in emotionally exhausted patients. The premonitory symptoms of suicide include verbal communications, suicide attempts, symptomatic actions, depression, treatment failure, excessive emotional reactions to specific disease states and panic reactions.Of persons who committed suicide, 75 per cent had seen a physician within six months. To recognize and evaluate suicide danger the physician must not be afraid to question the patient directly about his suicidal plans. The average physician encounters half a dozen suicidal patients a year and will have 10 to 12 suicides in his practice during a long career.In treating suicidal patients, the physician should maintain his medical attitude. The patients need emergency medical care including appropriate drugs. Free communication between patient and physician is very important. This may take some extra time. Patients benefit from emergency psychological support and stimulation toward constructive action. Family, friends, and community agencies should be mobilized to aid the patient. For seriously suicidal patients, consultation is recommended and treatment in hospital is advisable.
自杀危机最好被理解为情绪耗尽的患者适应行为逐渐崩溃的晚期阶段。自杀的先兆症状包括言语交流、自杀未遂、症状性行为、抑郁、治疗失败、对特定疾病状态的过度情绪反应和恐慌反应。在自杀者中，75%的人在六个月内看过医生。为了识别和评估自杀风险，医生绝不能害怕直接询问患者的自杀计划。普通医生每年会遇到半打有自杀倾向的患者，在漫长的职业生涯中，其诊治的患者中会有10至12人自杀。在治疗有自杀倾向的患者时，医生应保持其医疗态度。患者需要紧急医疗护理，包括使用适当的药物。患者与医生之间的自由交流非常重要。这可能需要一些额外的时间。患者会从紧急心理支持和促进行为建设的激励中受益。应动员家人、朋友和社区机构来帮助患者。对于严重有自杀倾向的患者，建议进行会诊，住院治疗为宜。
