{"title":"自杀风险的评估和管理:精神科医生应该知道的","authors":"Maurizio Pompili","doi":"10.1080/09540261.2023.2276898","DOIUrl":null,"url":null,"abstract":"AbstractSuicide is a major public health issue worldwide, and scholars now recognise the multifactorial perspective of this phenomenon. However, psychiatric disorders are often considered the main determinant of suicide risk, and psychiatrists are commonly requested to assess and manage such a risk. The establishment of the medical model suggests that treating mental disorders prioritises reducing the probability of a suicidal gesture. However, this model appears obsolete and implies that the entire management of such a complex phenomenon relies on psychiatrists’ treatments. In their central role, psychiatrists and other figures can reasonably anticipate the future by proper suicide risk assessment and appropriate documentation of therapeutic plans. In its unpredictability, clinicians should relate the suicidal phenomenon to foreseeability, with proper implementation of the standard of care, which ensures adequate protection from medical-legal instances. Psychiatrists should be trained to assess and manage suicide risk through clinical skills while fostering alliances with patients, families, and other clinicians. The article introduces the importance of suicide risk formulation, the correct categorisation of each patient by an in-depth study of the suicidal scenario, and the role of mental pain as a critical factor for reducing the main sources of suffering in each unique patient.Keywords: Suicidepsychiatryassessmentmanagementstandard of care Disclosure statementThe author declares no conflicts of interest. He wishes to disclose that in the last two years, he has received lecture and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Janssen, Lundbeck, MSD, Otsuka, Rovi, Pfizer, Fidia, Viatris and Recordati, all of which are unrelated to this article.","PeriodicalId":51391,"journal":{"name":"International Review of Psychiatry","volume":"173 2","pages":"0"},"PeriodicalIF":3.7000,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment and Management of Suicide Risk: What Psychiatrists Should Know\",\"authors\":\"Maurizio Pompili\",\"doi\":\"10.1080/09540261.2023.2276898\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"AbstractSuicide is a major public health issue worldwide, and scholars now recognise the multifactorial perspective of this phenomenon. However, psychiatric disorders are often considered the main determinant of suicide risk, and psychiatrists are commonly requested to assess and manage such a risk. The establishment of the medical model suggests that treating mental disorders prioritises reducing the probability of a suicidal gesture. However, this model appears obsolete and implies that the entire management of such a complex phenomenon relies on psychiatrists’ treatments. In their central role, psychiatrists and other figures can reasonably anticipate the future by proper suicide risk assessment and appropriate documentation of therapeutic plans. In its unpredictability, clinicians should relate the suicidal phenomenon to foreseeability, with proper implementation of the standard of care, which ensures adequate protection from medical-legal instances. Psychiatrists should be trained to assess and manage suicide risk through clinical skills while fostering alliances with patients, families, and other clinicians. The article introduces the importance of suicide risk formulation, the correct categorisation of each patient by an in-depth study of the suicidal scenario, and the role of mental pain as a critical factor for reducing the main sources of suffering in each unique patient.Keywords: Suicidepsychiatryassessmentmanagementstandard of care Disclosure statementThe author declares no conflicts of interest. He wishes to disclose that in the last two years, he has received lecture and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Janssen, Lundbeck, MSD, Otsuka, Rovi, Pfizer, Fidia, Viatris and Recordati, all of which are unrelated to this article.\",\"PeriodicalId\":51391,\"journal\":{\"name\":\"International Review of Psychiatry\",\"volume\":\"173 2\",\"pages\":\"0\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2023-11-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Review of Psychiatry\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/09540261.2023.2276898\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Review of Psychiatry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/09540261.2023.2276898","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Assessment and Management of Suicide Risk: What Psychiatrists Should Know
AbstractSuicide is a major public health issue worldwide, and scholars now recognise the multifactorial perspective of this phenomenon. However, psychiatric disorders are often considered the main determinant of suicide risk, and psychiatrists are commonly requested to assess and manage such a risk. The establishment of the medical model suggests that treating mental disorders prioritises reducing the probability of a suicidal gesture. However, this model appears obsolete and implies that the entire management of such a complex phenomenon relies on psychiatrists’ treatments. In their central role, psychiatrists and other figures can reasonably anticipate the future by proper suicide risk assessment and appropriate documentation of therapeutic plans. In its unpredictability, clinicians should relate the suicidal phenomenon to foreseeability, with proper implementation of the standard of care, which ensures adequate protection from medical-legal instances. Psychiatrists should be trained to assess and manage suicide risk through clinical skills while fostering alliances with patients, families, and other clinicians. The article introduces the importance of suicide risk formulation, the correct categorisation of each patient by an in-depth study of the suicidal scenario, and the role of mental pain as a critical factor for reducing the main sources of suffering in each unique patient.Keywords: Suicidepsychiatryassessmentmanagementstandard of care Disclosure statementThe author declares no conflicts of interest. He wishes to disclose that in the last two years, he has received lecture and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Janssen, Lundbeck, MSD, Otsuka, Rovi, Pfizer, Fidia, Viatris and Recordati, all of which are unrelated to this article.
期刊介绍:
The International Review of Psychiatry is the premier review journal in the field with a truly international authorship and readership. Each bimonthly issue is dedicated to a specific theme relevant to psychiatry, edited by recognized experts on the topic, who are selected by the Editors and the Editorial Board. Each issue provides in-depth, scholarly reviews of the topic in focus. The Journal reaches a broad international readership including clinicians, academics, educators, and researchers who wish to remain up-to-date with recent and rapid developments in various fields of psychiatry. It aims to be of value to trainees by choosing topics of relevance to career development, which are also suitable for clinicians for continuing professional development.