Psychiatr. Pol. 2017; 51(3): 531–548

DOI: http://dx.doi.org/10.12740/PP/OnlineFirst/36294

Paweł Rodziński, Krzysztof Rutkowski, Agnieszka Murzyn, Jerzy A. Sobański,
Katarzyna Cyranka, Edyta Dembińska, Karolina Grządziel, Katarzyna Klasa,
Michał Mielimąka, Łukasz Müldner-Nieckowski, Bogna Smiatek-Mazgaj


Zmiany w nasileniu objawów nerwicowych wiążące się z redukcją myśli samobójczych u pacjentów poddanych psychoterapii w dziennym oddziale leczenia nerwic i zaburzeń behawioralnych

Changes in intensity of neurotic symptoms associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders

In clinical practice suicidal ideation (SI) is one of the most commonly encountered symptoms in patients with mental disorders. Such encounter calls for diligent evaluation of suicidal risk. Although the risk factors are widely known, accurate estimation of suicidal risk remains one of the most difficult and most important tasks that clinicians face – especially considering recently collected data showing increase in suicide prevalence in Poland. More thorough estimation of suicidal risk in patients with SI requires taking under consideration not only suicidal risk factors but also factors that are more specific for progression of SI to suicidal behaviors (SB). The review presented in this paper consists of a range of suicidological theories that allow to select a number of groups of factors and mechanisms that are most specific for progression of SI to SB. These groups include: (1) transgression of fear of causing harm and pain to oneself, as well as disintegration of other protective barriers such as (2) decline of social integration with others, feeling of being alienated or abandoned, decline of sense of belongingness, lack of social support, (3) resignation from family and social obligations, (4) dismissing cultural or religious norms, (5) rejection of life goals, values and aspirations that were appreciated earlier, (6) narrowing down in perceived alternatives for suicide, i.e., “tunnel vision”, feelings of helplessness and powerlessness, (7) devising in details and accepting simple suicidal plan, especially when such plan is being consolidated through rehearsals and as if “automatized”, (8) impulsiveness, (9) accumulation of aggression that may be vented out as suicide, and finally (10) accessibility of means to commit suicide.

ISSN 0033-2674 (PRINT)

ISSN 2391-5854 (ONLINE)

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