Az európai pszichiátriai szövetség (European Psychiatric Association, EPA) úmutatója az öngyilkosság kezelésére és megelo{double acute}zésére

Translated title of the contribution: The european psychiatric association (EPA) guidance on suicide treatment and prevention

Danuta Wasserman, Z. Ríhmer, Dan Rujescu, Marco Sarchiapone, Marcus Sokolowski, David Titelman, Gil Zalsman, Zvi Zemishlany, És Vladimir Carli

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Suicide is a major public health problem in the WHO European Region accounting for over 150,000 deaths per year. Suicidal crisis: Acute intervention should start immediately in order to keep the patient alive. Diagnosis: An underlying psychiatric disorder is present in up to 90% of people who completed suicide. Comorbidity with depression, anxiety, substance abuse and personality disorders is high. In order to achieve successful prevention of suicidality, adequate diagnostic procedures and appropriate treatment for the underlying disorder are essential. Treatment: Existing evidence supports the efficacy of pharmacological treatment and cognitive behavioural therapy (CBT) in preventing suicidal behaviour. Some other psychological treatments are promising, but the supporting evidence is currently insufficient. Studies show that antidepressant treatment decreases the risk for suicidality among depressed patients. However, the risk of suicidal behaviour in depressed patients treated with antidepressants exists during the first 10-14 days of treatment, which requires careful monitoring. Short-term supplementary medication with anxiolytics and hypnotics in the case of anxiety and insomnia is recommended. Treatment with antidepressants of children and adolescents should only be given under supervision of a specialist. Long-term treatment with lithium has been shown to be effective in preventing both suicide and attempted suicide in patients with unipolar and bipolar depression. Treatment with clozapine is effective in reducing suicidal behaviour in patients with schizophrenia. Other atypical antipsychotics are promising but more evidence is required. Treatment team: Multidisciplinary treatment teams including psychiatrist and other professionals such as psychologist, social worker, and occupational therapist are always preferable, as integration of pharmacological, psychological and social rehabilitation is recommended especially for patients with chronic suicidality. Family: The suicidal person independently of age should always be motivated to involve family in the treatment. Social support: Psychosocial treatment and support is recommended, as the majority of suicidal patients have problems with relationships, work, school and lack functioning social networks. Safety: A secure home, public and hospital environment, without access to suicidal means is a necessary strategy in suicide prevention. Each treatment option, prescription of medication and discharge of the patient from hospital should be carefully evaluated against the involved risks. Training of personnel: Training of general practitioners (GPs) is effective in the prevention of suicide. It improves treatment of depression and anxiety, quality of the provided care and attitudes towards suicide. Continuous training including discussions about ethical and legal issues is necessary for psychiatrists and other mental health professionals.

Original languageHungarian
Pages (from-to)113-136
Number of pages24
JournalNeuropsychopharmacologia Hungarica
Volume14
Issue number2
Publication statusPublished - 2012

Fingerprint

Suicide
Psychiatry
Therapeutics
Antidepressive Agents
Anxiety
Psychology
Social Support
Pharmacology
Depression
Crisis Intervention
Attempted Suicide
Patient Discharge
Quality of Health Care
Clozapine
Public Hospitals
Personality Disorders
Anti-Anxiety Agents
Sleep Initiation and Maintenance Disorders
Cognitive Therapy
Depressive Disorder

ASJC Scopus subject areas

  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Neuropsychology and Physiological Psychology
  • Clinical Neurology

Cite this

Az európai pszichiátriai szövetség (European Psychiatric Association, EPA) úmutatója az öngyilkosság kezelésére és megelo{double acute}zésére. / Wasserman, Danuta; Ríhmer, Z.; Rujescu, Dan; Sarchiapone, Marco; Sokolowski, Marcus; Titelman, David; Zalsman, Gil; Zemishlany, Zvi; Carli, És Vladimir.

In: Neuropsychopharmacologia Hungarica, Vol. 14, No. 2, 2012, p. 113-136.

Research output: Contribution to journalArticle

Wasserman, D, Ríhmer, Z, Rujescu, D, Sarchiapone, M, Sokolowski, M, Titelman, D, Zalsman, G, Zemishlany, Z & Carli, ÉV 2012, 'Az európai pszichiátriai szövetség (European Psychiatric Association, EPA) úmutatója az öngyilkosság kezelésére és megelo{double acute}zésére', Neuropsychopharmacologia Hungarica, vol. 14, no. 2, pp. 113-136.
Wasserman, Danuta ; Ríhmer, Z. ; Rujescu, Dan ; Sarchiapone, Marco ; Sokolowski, Marcus ; Titelman, David ; Zalsman, Gil ; Zemishlany, Zvi ; Carli, És Vladimir. / Az európai pszichiátriai szövetség (European Psychiatric Association, EPA) úmutatója az öngyilkosság kezelésére és megelo{double acute}zésére. In: Neuropsychopharmacologia Hungarica. 2012 ; Vol. 14, No. 2. pp. 113-136.
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