Citation

Kozaric-Kovacic D, Jendričko T. Medicus 2004; 13(1): 77-87.

Copyright

(Copyright © 2004)

DOI

unavailable

PMID

unavailable

Abstract

People with mental disorders commit about 90% of all suicides. Affective disorders (serious depression, bipolar disorder and schizoaffective disorder) are diagnosed in 60% to 70% of suicides. A lifetime risk of suicide in people suffering from depression is 15%. Some suicidal risk factors include: suicidal or homicidal thoughts, intentions and plans; access to the methods for committing suicide and their lethality; presence of psychotic symptoms, imperative hallucinations or serious anxiety; abuse of alcohol or psychoactive substances; history and seriousness of previous attempts, and positive family history. In clinical practice, it is important to evaluate the risk of suicide and its intensity. As suicide is neither a mental disorder nor a psychiatric diagnostic category, the treatment mainly focuses on a bipolar disorder. Although there is no specific pharmacotherapy, various drug classes are used. The question whether certain drugs can intensify or prevent suicidal behavior in people with increased risk is very controversial. By treating the symptoms, we influence the expression of suicidal behavior. However, the research shows that a recent increase in the prescription of antidepressants contributed to a drop in the suicide rate. Specific therapies for suicidal behavior include: 1) somatic therapy and 2) psychotherapy. The choice of psychopharmaceuticals depends on disease stage, suicidal risk, drug safety and efficacy, side effects or interactions with other medications, patient compliance, social support, and physical comorbidity. The preventive procedures comprise adequate and timely recognition of the underlying psychiatric disease, comorbidity (psychiatric or physical) and suicidal behavior in patients along with the introduction of appropriate psychopharmaceuticals and psychotherapeutic and psychosocial procedures.

Language: hr

Keywords

human; Depression; homicide; suicide; alcohol; bipolar disorder; lethality; psychotherapy; depression; Suicidality; social support; psychosis; suicidal behavior; comorbidity; drug abuse; Pharmacotherapy; mood disorder; risk factor; review; alcohol abuse; mental disease; clinical practice; antidepressant agent; monoamine oxidase inhibitor; social psychology; anxiety disorder; psychotropic agent; electroconvulsive therapy; drug safety; family history; patient compliance; drug efficacy; anamnesis; side effect; schizoaffective psychosis; Therapeutic approaches