Suicidality comprising completed suicide, suicidal attempt (to die having at least a certain intention) and suggestive gestures; Suicidal thoughts are thoughts and plans about suicide. A psychiatric referral is usually required.

Suicidality comprising completed suicide, suicidal attempt (to die having at least a certain intention) and suggestive gestures; Suicidal thoughts are thoughts and plans about suicide. A psychiatric referral is usually required.

(. Suicidal behavior) suicidality comprising completed suicide, suicidal attempt (at least with a certain intention to die) and suggestive gestures; Suicidal thoughts are thoughts and plans about suicide. A psychiatric referral is usually required. The suicide rate among young people has declined in recent years after a decade of constant rising again, but only to rise again again. The exact reasons for these variations are not clear. Many experts believe that the changing ways in which antidepressants are prescribed, may be a factor (Depression in Children and Adolescents: suicide risk and antidepressants). Some experts suggest that antidepressants have a paradoxical effect, so that children and young people to articulate more clearly their suicidal thoughts, but rarely put suicide into action. Although it is rare in prepubertal children, is suicide but the second or third leading cause of death among 15-19 year olds and remains a major public health problem. Etiology in children and adolescents, the risk of suicidal behavior by the presence of other mental disorders and other diseases that affect the brain, family history, psychosocial and environmental factors (see Table: Risk factors for suicidal behavior in children and adolescents) affected. Risk factors for suicidal behavior in children and adolescents Type Examples Mental disorders and physical diseases that affect the brain affective disorders * (z. B. unipolar or bipolar depression) schizophrenia alcohol and / or substance use in adolescents Aggressive, impulsive tendencies (conduct disorder) Early suicide attempts Traumatic head injuries posttraumatic stress disorder (PTSD) family history family history of suicidal behavior parent with a mood disorder father with a history vo n problems with the police Inadequate communication with parents Recent Psychosocial factors disciplinary action † (most often school suspension) Interpersonal loss (loss of a firm friend or a solid friend, especially in boys; Separation from parents) difficulties in school Social isolation (especially not work or study) minorities in households with upward mobility victim of bullying media reports of suicide (suicide imitators) environmental factors Easy access to lethal methods (eg. As guns) barriers and / or stigma associated with the access to services of mental health * mood disorders are more than half of suicidal adolescents. † Almost half of completed suicides occur after recent disciplinary action. Other factors include lack of structures and boundaries, which can lead to an overwhelming sense of disorientation, or the pressure to succeed in some families where the child or young person is convinced that he can not live up to expectations. A common motive for a suicide attempt is an attempt to manipulate others or to punish with the idea “You’ll be sorry when I’m dead.” Protective factors include effective clinical care for mental, physical and substance use disorders Easy access to clinical interventions Family and social support ( “connectedness”) skills in conflict resolution Cultural and religious beliefs that the suicide discourage treatment crisis intervention, possibly including hospitalization Psychotherapy Possibly drugs to treat of underlying medical conditions, usually in combination with psychotherapy Psychiatric Transfer Every suicide attempt is a serious matter and requires a carefully considered and appropriate intervention. Once the immediate threat to life has been eliminated, a decision on the need for hospitalization must be made. The decision is based on the balance between the base of the risk and the ability of the family to offer support. The hospitalization (also an open station with specially trained personnel) is the safest way of short-term protection and is usually indicated for depression, psychosis or suspected both. The lethality of suicidal intentions can be evaluated based on the following criteria: degree of proven planning (. Eg by writing a suicide note) Under Exempt steps to avoid detection used or planned method (eg, firearms are more lethal than. pills) degree of sustained self-harm circumstances or history of factors surrounding the experimental state of mind at the time of the episode (acute agitation aroused particular concern) recent release from inpatient care recent discontinuation of psychotropic drugs, the drug therapy needs (in accordance with the underlying disorder such. as depression , bipolar or behavioral disorder, psychosis) are selected, but can not prevent suicide. In fact, the use of antidepressants, the risk of suicide in some adolescents increase (Depression in Children and Adolescents: suicide risk and antidepressants). The use of medication should be carefully monitored, and only sublethal amounts should be issued. A psychiatric referral is usually required in order to offer an appropriate drug treatment and psychotherapy. A cognitive behavioral therapy for suicide prevention and a dialectical behavioral therapy may be preferred. Treatment is most successful when the family doctor is still involved in the treatment. Of fundamental importance for the subsequent treatment of the reconstruction of mental equilibrium in the family is. A negative or not supporting parental reaction is very questionable and can lead to increased intervention up to institutionalization. A positive result is most likely when the family shows love and concern. Prevention of suicide cases often preceded by visits by children and adolescents in the clinic, in which in recent years reveal possibly behavioral changes (eg. As despondency, truant low self-esteem, sleep and appetite disturbances, difficulty concentrating, school, somatic complaints and employment suicidal thoughts). Statements such as “I wish I had never been born” or “I would like to fall asleep and never wake up” should be taken very seriously as a possible indication of a suicide intent. The threatening with or attempt of suicide provides an important insight into the intensity of the experienced distress. Early detection of the above mentioned risk factors can help prevent a suicide attempt. In response to these early hints or confrontation with hard coercive or attempted suicide or risky behavior clearly a spirited intervention is necessary. Through these direct questions, the suicide risk can be reduced. Adolescents should be asked directly about their unfortunate and self-destructive feelings. The physician should not calm down for no reason before he does not understand the circumstances in question, for lack of understanding is able to undermine his credibility and further reduce the self-esteem of adolescents. The effectiveness of prevention programs is being explored at the moment. The most effective programs are those that will endeavor to ensure that the child has a supportive, nurturing environment and easy access to mental health services. Importantly a social environment that is characterized by respect for the individual, ethnic and cultural differences. In the United States lists the SPRC Suicide Prevention Resource Center lists some of these programs, and the National Suicide Prevention Lifeline (1-800-273-TALK) offers crisis intervention for individuals who threaten suicide. Non-suicidal self-harm non-suicidal self-injurious behavior may include superficial scratching, cutting ( “cracks”) or burning of the skin (with cigarettes or curling irons), and stinging, beating and repeatedly rubbing the skin with an eraser or salt. In some areas, this self-injurious behavior as a sort of fad by the schools haunts, only to disappear with time. Such behaviors are often associated with illegal drug abuse and suggest that a young person is in great need. For many young people these behaviors do not indicate suicidal tendencies, but instead are acts of self-punishment, of which they feel they have to earn it; these behaviors are used to attract the attention of parents and / or caregivers to express anger or to identify with a group of peers. However, these young people, particularly those who have multiple methods of self-harm used at an increased risk of suicide. All self-injurious behavior should be assessed by a doctor who has experience in dealing with young people in problem situations has. He should find out whether suicidality is the cause and the nature of the underlying trouble is that has led to self-injurious behavior.

Health Life Media Team

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