“Suicide crisis”的意思、由来-开放百科全书

A suicide crisis, suicidal crisis, attempted suicide or potential suicide, is a situation in which a person is attempting to kill themselves or is seriously contemplating or planning to do so. It is considered by public safety authorities, medical practice, and emergency services to be a medical emergency, requiring immediate suicide intervention and emergency medical treatment. Suicidal presentations occur when there is an emotional problem or predicament that the individual cannot solve and suicide is a solution to them. Clinicians should re-frame suicidal crises, point out that suicide is not a solution and help the individual identify and solve or tolerate the problems.^[1]

Nature

Most cases of potential suicide have warning signs.^[2]^[3]^[4] Attempting to kill oneself, talking about or planning suicide, writing a suicide note, talking or thinking frequently about death, exhibiting a death wish by expressing it verbally or by taking potentially deadly risks, or taking steps towards attempting suicide (e.g., obtaining rope and tying it to a ligature point to attempt a hanging or stockpiling pills for an attempted overdose) are all indicators of a suicide crisis. More subtle clues include preparing for death for no apparent reason (such as putting affairs in order, changing a will, etc.), writing goodbye letters, and visiting or calling family members or friends to say farewell. The person may also start giving away previously valued items (because they "no longer need them"). In other cases, the person who seemed depressed and suicidal may become normal or filled with energy or calmness again; these people particularly need to be watched because the return to normalcy could be because they have come to terms with whatever act is next (e.g., a plan to attempt suicide and "escape" from their problems).

Suicide is often committed in response to a cause of depression, such as the cessation of a romantic relationship, serious illness or injury (like the loss of a limb or blindness), the death of a loved one, financial problems or poverty, guilt or fear of getting caught for something the person did, drug abuse, old age, concerns with gender identity, among others.^[9]

In 2006, WHO conducted a study on suicide around the world. The results in Canada showed that 80-90% of attempts failed (an estimation, due to the complications of predicting attempted suicide). 90% of failed suicides investigated led to hospitalizations. 12% of attempts were in hospitals.

Treatments

Ketamine has been clinically tested for treatment-resistant bipolar depression, major depressive disorder, and people in a suicidal crisis in emergency rooms, and is being used this way off-label.^[10]^[11]^[12] The drug is given by a single intravenous infusion at doses less than those used in anesthesia, and preliminary data have indicated it produces a rapid (within 2 hours) and relatively sustained (about 1–2 weeks long) significant reduction in symptoms in some patients.^[13] Initial studies with ketamine have sparked scientific and clinical interest due to its rapid onset,^[14] and because it appears to work by blocking NMDA receptors for glutamate, a different mechanism from most modern antidepressants that operate on other targets.^[11]^[15] Some studies have shown that Lithium can reduce suicidal ideation within 48 hours of administration.

See also

References

1. ^{{Cite journal| last = Murray| first = Declan| date = 2016-02-18| title = Is it time to abandon suicide risk assessment?| url = http://bjpo.rcpsych.org/content/2/1/e1| journal = British Journal of Psychiatry Open| language = en| volume = 2| issue = 1| pages = e1–e2| doi = 10.1192/bjpo.bp.115.002071| issn = 2056-4724| pmc = 4998936| pmid=27703761}}
2. ^{{cite journal| pmc=5064427 | pmid=22796102 | doi=10.1016/j.psychres.2012.06.036 | volume=200 | title=Warning signs for suicide within a week of healthcare contact in Veteran decedents | year=2012 | author=Britton PC, Ilgen MA, Rudd MD, Conner KR | journal=Psychiatry Res | pages=395–9}}
3. ^[https://thethreeseas.com.au/understanding-suicide/ thethreeseas.com.au]
4. ^health.umd.edu/node/791
5. ^Barker, P. (2003). Psychiatric and Mental Health Nursing The craft of caring. pp 227. New York, NY: Oxford University Press Inc.
6. ^{{cite web |title=Suicide and suicidal behavior |url=https://www.nlm.nih.gov/medlineplus/ency/article/001554.htm#Causes,%20incidence,%20and%20risk%20factors |date=15 January 2009 |work=MedlinePlus Medical Encyclopedia |accessdate=22 August 2009}}
7. ^{{cite web |author=Stewart, George |title=Suicide & Mental Distress |url=http://www.suicidereferencelibrary.com/test4~id~1619.php |archiveurl=https://web.archive.org/web/20070930224643/http://www.suicidereferencelibrary.com/test4~id~1619.php |year=2004 |archivedate=30 September 2007 |work=Suicide Reference Library |accessdate=22 August 2009}}
8. ^{{cite web |title=Understanding the Symptoms of Depression |url=http://www.webmd.com/depression/guide/understanding-depression-symptoms |date=12 November 2008 |publisher=WebMD |accessdate=22 August 2009}}
9. ^{{cite web |title=Suicide |url=https://www.healthforums.com/library/1,1258,article~6229,00.html |date=2 March 2004 |accessdate=22 August 2009}}
10. ^*Gary Stix for Scientific American. September 11, 2013 From Club to Clinic: Physicians Push Off-Label Ketamine as Rapid Depression Treatment, Part 1* Gary Stix for Scientific American. September 12, 2013 Is Ketamine Right for You? Off-Label Prescriptions for Depression Pick Up in Small Clinics, Part 2* Gary Stix for Scientific American. September 13, 2013 Ketamine, a Darling of the Club Scene, Inspires Development of Next-Generation Antidepressants, Part 3
11. ^¹Caddy C et al. Ketamine as the prototype glutamatergic antidepressant: pharmacodynamic actions, and a systematic review and meta-analysis of efficacy. Ther Adv Psychopharmacol. 2014 Apr;4(2):75-99. {{doi|10.1177/2045125313507739}}. Review. {{PMID|24688759}} {{PMC|3952483}}
12. ^Tondo L et al. Options for pharmacological treatment of refractory bipolar depression. Curr Psychiatry Rep. 2014 Feb;16(2):431. {{doi|10.1007/s11920-013-0431-y}}. Review. {{PMID|24425269}}
13. ^ECRI Institute, under contract to AHRQ. December 2013 AHRQ Healthcare Horizon Scanning System – Potential High-Impact Interventions Report. Priority Area 05: Depression and Other Mental Health Disorders {{Webarchive|url=https://web.archive.org/web/20140808052531/http://effectivehealthcare.ahrq.gov/ehc/assets/File/Depression-Horizon-Scan-High-Impact-1312.pdf |date=2014-08-08 }}
14. ^{{cite press release |url= http://www.nih.gov/news/pr/aug2006/nimh-07b.htm |title= Experimental Medication Kicks Depression in Hours Instead of Weeks |work= NIH News |date= 7 August 2006 |author= National Institute of Mental Health |publisher= National Institutes of Health; Dept. of Health and Human Services; United States|quote= National Institute of Mental Health director Thomas Insel said, "To my knowledge, this is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response with a single dose. These were very treatment-resistant patients."}}
15. ^{{cite journal|last1=Naughton|first1=M|last2=Clarke|first2=G|last3=O'Leary|first3=OF|last4=Cryan|first4=JF|last5=Dinan|first5=TG|title=A review of ketamine in affective disorders: current evidence of clinical efficacy, limitations of use and pre-clinical evidence on proposed mechanisms of action.|journal=Journal of Affective Disorders|date=Mar 2014|volume=156|pages=24–35|pmid=24388038|doi=10.1016/j.jad.2013.11.014}}

Nature

Treatments

See also

References

External links