Managing suicide risk in patients with schizophrenia.
Managing suicide risk in patients with schizophrenia.
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DOI：
10.2165/11586450-000000000-00000
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发表时间：
2011-02
期刊：
影响因子：
6
通讯作者：
Zisook S
中科院分区：
文献类型：
--
作者：
Kasckow J;Felmet K;Zisook S
精神分裂症患者自杀风险的管理给临床医生带来了许多挑战。与一般人群相比，这些患者的自杀风险高出 8.5 倍。本文回顾了有关高危精神分裂症患者治疗的文献。建议采用综合心理社会和药理学方法来管理此类患者。尽管至少有适度的证据表明抗精神病药物可以预防自杀风险，但证据似乎最有利于第二代抗精神病药物，尤其是氯氮平，它是美国 FDA 批准的唯一用于预防精神分裂症患者自杀的药物。此外，治疗精神分裂症患者的抑郁症状是降低自杀风险的重要组成部分。虽然选择性血清素受体抑制剂（SSRI）可以改善精神分裂症患者的抑郁症状，但它们似乎也可以减弱自杀念头。需要进一步的研究来更有效地个性化治疗自杀想法和行为以及预防精神分裂症患者的自杀。
The management of suicide risk in patients with schizophrenia poses many challenges for clinicians. Compared with the general population, these patients have an 8.5-fold greater risk of suicide. This article reviews the literature dealing with the treatment of at-risk patients with schizophrenia. An integrated psychosocial and pharmacological approach to managing this population of patients is recommended. Although there is at least modest evidence suggesting that antipsychotic medications protect against suicidal risk, the evidence appears to be most favourable for second-generation antipsychotics, particularly clozapine, which is the only medication approved by the US FDA for preventing suicide in patients with schizophrenia. In addition, treating depressive symptoms in patients with schizophrenia is an important component of suicide risk reduction. While selective serotonin receptor inhibitors (SSRIs) ameliorate depressive symptoms in patients with schizophrenia, they also appear to attenuate suicidal thoughts. Further research is needed to more effectively personalize the treatment of suicidal thoughts and behaviours and the prevention of suicide in patients with schizophrenia.
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