Citation

Michel K. Psychiatr. Danub. 2006; 18(Suppl 1): 78-79.

Affiliation

Universitaren Psychiatrische Dienste (UPD), Murtenstrasse 21, CH-3010 Bern, Switzerland. (konrad.michel@spk.unibe.ch)

Copyright

(Copyright © 2006, Facultas Universitatis Studiorum Zagrabiensis - Danube Symposion of Psychiatry)

DOI

unavailable

PMID

16963988

Abstract

Adequate prescribing of psychotropic drugs for the treatment of mental disorders associated with a high risk of suicide can reduce the frequency of suicidal behaviour. However, suicide and attempted suicide are not illnesses but behaviours, and the patients' needs are not met when the prevention of suicide is equated with the treatment of psychiatric diagnosis. Patients who attempt suicide often drop out of aftercare prematurely. This is a major obstacle to suicide prevention, as, after attempted suicide, the risk of suicide is increased dramatically and remains high over years. After a first suicidal action, this will be established as a response to future emotional crises (mental pain experiences), and outcome will largely be a matter of emotion regulation in the acute situation. The clinician therefore has two tasks: To prevent patients from committing suicide in the acute crisis (or after a suicide attempt), and to secure that in a long term perspective patients have established emergency strategies against the suicidal urge in future critical situations. Clinical practice implies that a therapeutic relationship with the suicidal patient is basic to prevention. Where pharmacotherapy is indicated, it should be an integral part of a patient-oriented treatment protocol, and the goals of the use of drugs should be clear to the patient. This means that the rationale of the drug use must also be clear in the therapist's mind. Patients need adequate information and education about the medication to ensure motivation and cooperation. Attitudes towards psychotropic drugs must be discussed with an open mind. Pharmacotherapy can then be an important "object" in the therapeutic relationship.

Language: en