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Psychiatrie und Psychotherapie up2date 2009; 3(03): 197-212
DOI: 10.1055/s-0028-1090210
Störungsübergreifende Themen und Methoden

Suizidalität

Erik Lauterbach
,
Thorsten Kienast
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Kernaussagen

  • Suizide und Suizidversuche stellen weltweit eine erhebliche Herausforderung für das öffentliche Gesundheitswesen dar.

  • Major Depression und bipolare Störungen sind mit der höchsten Suizidrate assoziiert, insbesondere bei komorbider Abhängigkeitserkrankung.

  • Hauptrisikofaktoren für einen Suizid sind neben dem Vorliegen einer psychiatrischen Erkrankung hohes Alter, männliches Geschlecht, fehlender Zugang zu fachspezifischer Behandlung und Arbeitslosigkeit.

  • Wichtigster Prädiktor ist ein Suizidversuch in der Vorgeschichte.

  • Ätiologisch spielt eine verminderte serotonerge Neurotransmission, insbesondere im präfrontalen Kortex, eine entscheidende Rolle.

  • Lithium hat eine sichere suizidprotektive Wirkung bei bipolarer Störung, mit leicht geringerer Wirksamkeit auch bei unipolaren Depressionen oder rezidivierenden depressiven Störungen; Clozapin ist wirksam in der Suizidprophylaxe bei Schizophrenie.



Publication History

Publication Date:
11 May 2009 (online)

© Georg Thieme Verlag KG Stuttgart · New York

 

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