Medicus, Vol. 13 No. 1_Depresija, 2004.
Review article
Suicidality and Depression
Dragica Kozarić-Kovačić
Tihana Jendričko
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.
Keywords
suicidality; depression; pharmacotherapy; therapeutic approaches
Hrčak ID:
19809
URI
Publication date:
26.1.2004.
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