Etzersdorfer E, Vijayakumar L, Schöny W, Grausgruber A, Sonneck G
University Clinic for Psychoanalysis and Psychotherapy, University of Vienna, Austria.
Soc Psychiatry Psychiatr Epidemiol. 1998 Mar;33(3):104-10. doi: 10.1007/s001270050029.
Attitudes towards suicide among medical students in Madras (India) and Vienna (Austria) were compared using the SUIATT questionnaire by Diekstra and Kerkhof (1989). Results show a very restrictive attitude in Madras, rejecting the right to commit suicide, nearly always judging suicide as a cowardly act, and rejecting the idea of assisted suicide. On the other hand, in Vienna a more permissive attitude was found. It is interpreted that the Indian pattern comes close to a "medical" or "disease model", with stronger emphasis on mental illness, impulsiveness and emotional aspects, whereas the Viennese pattern reflects a "theoretical", "rational model", concentrating on cognitive factors and minimizing the influence of mental illness, emotional difficulties and restrictions related to suicidal behaviour. This pattern may be influenced by the public discussion on assisted suicide and the right to die in Europe in the last decade. Possible relations to the risk for actual suicidal behaviour are discussed using respective answers concerning previous suicidal ideation and suicide attempts. The answers concerning suicidal ideation seem to be strongly influenced by the different attitude patterns: only 16.8% reported previous suicidal ideation in Madras, compared to 51.5% in Vienna, whereas the percentage of reported suicide attempts is equal in both centres (5.9%:4.9%).
使用迪克斯特拉和克尔霍夫(1989年)编制的SUIATT问卷,对印度马德拉斯和奥地利维也纳的医学生对自杀的态度进行了比较。结果显示,马德拉斯的态度非常保守,拒绝自杀权,几乎总是将自杀判定为懦弱行为,并拒绝协助自杀的想法。另一方面,在维也纳发现了更为宽容的态度。据解释,印度模式更接近“医学”或“疾病模式”,更加强调精神疾病、冲动性和情感方面,而维也纳模式则反映了一种“理论”“理性模式”,侧重于认知因素,并将精神疾病、情感困扰以及与自杀行为相关的限制的影响最小化。这种模式可能受到过去十年欧洲关于协助自杀和死亡权利的公开讨论的影响。使用关于先前自杀意念和自杀未遂的相应回答,讨论了与实际自杀行为风险的可能关系。关于自杀意念的回答似乎受到不同态度模式的强烈影响:在马德拉斯,只有16.8%的人报告有过自杀意念,而在维也纳这一比例为51.5%,而两个中心报告的自杀未遂比例相当(5.9%:4.9%)。