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DOI: 10.1055/s-0038-1628810
Umgang mit selbstverletzendem Verhalten, Suizidalität und manipulativer Suizidalität
Stationäre Behandlung von Patientinnen mit Borderline-PersönlichkeitsstörungManagement of deliberate self-harm, suicidal tendency, and manipulative suicidal tendency duringIn-patient treatment of patients with borderline personality disorderPublication History
Eingegangen am:
25 August 2009
angenommen am:
25 August 2009
Publication Date:
24 January 2018 (online)
Zusammenfassung
Selbstverletzendes Verhalten ist bei Patientinnen mit Borderline-Persönlichkeitsstörung häufig und kann viele psychische, soziale und zum Teil auch neurobiologische Funktionen erfüllen. Suizidversuche sind ebenfalls häufig und indizieren ein erhöhtes Suizidrisiko. Bis zu 10% der Patientinnen versterben an Suizid, der Anteil an allen Suiziden wird zwischen 9 und 33% geschätzt. Suizidalität ist deshalb der typische Einweisungsgrund für eine stationäre Behandlung. Trotz des im Langzeitverlauf erhöhten Suizidrisikos muss die Indikation für eine stationäre Behandlung kritisch beurteilt werden. Regressive Tendenzen mit manipulativer Suizidalität, gehäuften Selbstverletzungen und Abgabe von Selbstverantwortung werden gefördert, wenn es nicht gelingt, eine Behandlungsstrategie zur Stärkung der Eigenverantwortung zu etablieren. Diesbezügliche Empfehlungen werden aus den klinischen Erfahrungen einer Kriseninterventionsstation abgeleitet.
Summary
Self-harm is by definition frequent among patients with borderline personality disorder. It has various mental, social, and even neurobiological functions. Suicide attempts are frequent and indicate an increased suicide risk. Up to 10% of patients die from suicide, the percentage among all suicides is estimated between 9 and 33%. Therefore suicidal tendency is a typical reason for admission. Despite the elevated long-term suicide risk, hospital admission and length of stay have to be discussed critically, since evidence for its benefit is scarce. Hospitalisation can promote regressive tendencies with “manipulative” suicidal behaviour, increasing acts of selfharm and delegation of self-responsibility. A strategy for the strengthening of individual responsibility is required. Recommendations are given from the experiences of a crisis intervention ward.
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