网范文：“Psychiatric diagnosis in attempted suicide ” 这是一个回顾性探讨,评估各种社会关联,采用的措施是针对自杀的问题，英语毕业论文，最常见的精神疾病诊断发现适应障碍抑郁症紧随其后。这篇心理范文对自杀未遂的情况进行探讨。自杀死亡率的主要原因何在，英语论文范文，这是一个悲剧,预防是一个公共卫生问题。在发达国家和发展中国家年轻人自杀率呈现上升趋势。近年来青少年自杀事件一直在增加。来自同辈的压力和情感问题触发，如果今天的年轻一代已经失去希望,对成人社会的挑战也可以让他们意识到生活是值得的。
自杀是自我造成的人类行为,承诺的狭隘思维,一种错误逻辑和急性痛苦。自杀未遂被定义为一个潜在的非致命结果,有证据表明,显式或隐式的个人打算杀死自己。行动可能会或可能不会导致伤害。根据国家犯罪记录局,在印度每5分钟一个人自杀。
ABSTRACT
This is a retrospective study which assesses the various socio-demographic correlates, the methods adopted to commit suicide and the psychiatric disorders in patients attempting suicide. The most common psychiatric diagnosis was found to be Adjustment disorder followed by Depressive disorder. Organo-phosphorous compounds were the most frequent agent used among suicide attempt patients.
Key words- attempted suicide, adjustment disorder, organophosphorous compounds, depressive disorder, and sociodemography
INTRODUCTION
Suicide is a major cause of mortality and use of health resources. It is also a tragic and serious preventable public health problem all over the world. (1, 20) Suicide rates among young people appear to be rising in both developed and developing countries more quickly than all other age groups. In recent times adolescent suicides have been on the increase.(1,2,3,12, 16).Exams, peer pressure and emotional issues are said to be the triggers (16). If the young generation of today have already run out of hope, the challenge lies in the hands of the adult society to make them realize that life is worth living (1,3).
Suicide is the human act of self inflicting, self intentioned cessation, committed out of constricted thinking, tunneled logic and acute anguish. Attempted suicide is defined as a potentially self injurious action with a non-fatal outcome for which there is evidence, either explicit or implicit that the individual intended to kill himself or herself. The action may or may not result in injuries.(4) Para suicide is a term introduced to describe patients who injure themselves by self-mutilation but who usually do not wish to die (21). Suicide because of its low base rate is virtually impossible to predict on a case by case basis (13).
Prevalence studies show between 4 – 12% of the general population have made at least one attempt and the repetition ratio (persons who attempt suicide again) is 50 %.( 5, 14) According to National Crime Records Bureau, in India every 5 minutes a person commits suicide, 7 attempts to kill themselves forming about 100,000 suicide death per year in India. South India formed by four states (Kerala, Tamil Nadu, Andhra Pradesh, and Union Territory of Pondicherry) records around 50,000 suicide deaths per year. The discrepancies in suicide rates between Southern India and other parts of India could be attributed to different ing and classification systems (22). Regarding the incidence of suicide in Kerala, the of the Government of India shows that the suicide rate is highest in the State of Kerala, ninth year in a row, when compared to other states in India (6, 14).
MATERIALS AND METHODS
This was a retrospective study conducted at Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India, which is a 1000 bedded medical college hospital catering to the health requirements of the people of Kannur District. The district has a number of private hospitals in addition to the Medical College which provide health care facilities to patients. All attempted suicide patients admitted in the Medical wards during the period 1/January/03 to 01/June/04 were included in the study. The patients who died after reaching the hospital and those died during the recovery phase from physical ill health following attempted suicide were excluded from the study. After admission, patients were treated in the wards or in the ICU.
These patients were referred to the consultant psychiatrists for evaluation after the physical condition was stabilized. The Hospital encourages psychiatric evaluation of all attempted suicide cases before discharge. A detailed clinical interview of each patient was conducted after the toxic effect of the substances ingested has subsided. The psychiatric assessment was done by consultant psychiatrists and a psychiatric diagnosis according to the ICD-10 was reached. The information regarding pre-morbid personality and illness was cross checked with a close relative or a reliable informant.
DISCUSSION
As the study was retrospective in nature it had it’s own inherent limitations and weaknesses. The clinical diagnosis was cross sectional and not by consensus. The study sample was fairly large. The Psychiatric referral rate was only 65% and was comparable to a study done at St.Johns Medical College, Bangalore (7). The reasons for not referring could be due to the stigma associated with psychiatric referral which could not be assessed since this was a retrospective study. In this study 45.6% (n=94) patients belonged to the age group 15 to 34 years, which was comparable to other studies done in Kerala (8). In the present study males constituted 65% (n=134) of the total sample and females 35% (n=72).
Comparing these figures with the number of completed suicide cases that underwent medico legal autopsy at the Forensic Department at Academy of Medical Science, Kannur, Kerala, India, it was found that males constituted 66% (n=245) and females 34% (n=135) of the completed suicide group during the same time period(9). Organo-phosphorus and Organo-carbamate poisoning was the most frequent method used by patients to attempt suicide and it was supported by other studies from India (7,8). This is explained by the easy availability of insecticides and pesticides in most households. Over dosage with prescription drugs such as barbiturates and anti-depressants were next most common employed methods.
IMPLICATIONS FOR PREVENTION
Suicide is a complex, long-term outcome that requires complex theoretical models for appropriate study and complex interventions for effective prevention. The highest likelihood of success in saving lives in the long run lies in well designed, comprehensive programs focused on prevention, identification and appropriate treatment of Mental and Addictive Disorders particularly in Primary care.(15,16,20) This could be facilitated by Continuing education for health care professional to identify and treat Mental illness and by making Psychiatric consultation mandatory for all patients admitted following attempted suicide.(7) At the policy and public health level, increased restrictions on access to most commonly used lethal methods of suicide especially insecticides (organophosphorus and organo-carbamate compounds) and prescription medications and improving control of facilitatory factors such as alcohol, influencing the media in their portrayal of suicide and ing of method may contribute to a reduction in suicide rates.(17,19)()
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