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Suicide and mental illness

　　Suicide is currently considered to be a multi-faceted disease, derived from the complex interaction of biological, psychological, social and environmental factors. Both developing and developed countries have pointed out two things: First, most suicide cases have a mental illness that can be diagnosed; second, people with mental illness have a higher chance of self-expression. Injury and suicidal behavior.

 

Mental diseases related to suicide are ranked in descending order of risk as follows:

Depression (all types)

Personality disorders (anti-social and marginal personality with tendency to be impulsive, aggressive, and frequent emotional changes)

Alcoholism (substance abuse and/or alcohol abuse in adolescents)

Schizophrenia

Organic mental illness

Other mental disorders

note:

Suicide itself is not a disease, nor is it necessarily the only manifestation of disease.

But mental illness is the main factor associated with suicide.

　　 According to research in developing and developed countries, the prevalence rate of people with mental illness in suicide cases is 80-100%. It is estimated that the lifelong suicide risk rate for people with affective psychosis (mainly depression) is 6-15%, alcohol addiction is 7-15%, and schizophrenia is 4-10%.The common feature of suicide victims is that they usually suffer from more than one disease. The most common diseases are alcohol addiction or affective psychosis (for example: depression), personality disorders or other mental illnesses.

Depression

　　All affective psychosis is related to suicide. These diseases include bipolar affective disorders, depression, relapsed depression, and persistent affective disorders (such as cyclic and depressed affective disorders). Therefore, undiagnosed or untreated depression is a significant risk factor for suicide. Depression has a high prevalence rate in the general population and is not generally considered a disease. It is estimated that about 30% of the patients who visit are suffering from depression. Approximately 60% of patients receiving treatment initially contacted general practitioners to seek treatment. It is a very special challenge for physicians to deal with physical and mental illnesses at the same time. Many examples tell us that the symptoms of depression are masked, but patients only show multiple physical complaints.

note:A typical depressive episode, the patient usually suffers from: low mood (sadness), loss of interest or happiness, reduced physical strength (tiredness, reduced activity)

Depression is the most common diagnosis in suicide deaths. Everyone will always feel melancholy, sad, lonely and emotionally unstable, but these usually pass. When these feelings persist and affect a person's normal life, it is no longer just a feeling of depression, but a state of depression.

Some common symptoms of depression are:

Feel sad for most of the day

Loss of interest in daily activities

Weight loss (when not on a diet) or weight gain

Sleeping too much or too little, or waking up too early

Always feel tired and weak

No sense of self-worth, guilt, or hopelessness

Always feel irritable and restless

Have difficulty concentrating, making decisions or remembering things

Repeated thoughts of death and suicide+

Body pain in different areas

The following symptoms remind physicians to pay attention to the existence of depression and assess the risk of suicide.

The clinical manifestations of suicide especially related to depression are:

Persistent insomnia

Self-ignorance

Serious illness (especially depression with psychotic characteristics)

Impaired memory

excitement

Panic attack

The following factors increase the risk of suicide in the depressed population:

Men older than 25 years old

Early disease

Alcohol abuse

Depression of bipolar affective disorder

Mixed (manic-depressive) state

Psychotic mania

Why depression is not discovered

Although there are many treatments for depression, they are often not diagnosed at all. The reasons are:

People are often ashamed to admit that they suffer from depression. This may be related to the fact that many people regard depression symptoms as a symbol of weakness.

People are not unfamiliar with the related feelings that accompany depression, so they do not regard it as a disease.

When a person has other physical illnesses at the same time, depression becomes less easy to diagnose.

A person with depression may only manifest with a lot of vague aches and pains.

Note: depression can be treated; suicide can be prevented

Depression is an important factor in suicide among the elderly and adolescents, and late-onset depression has a higher risk

    The progress in the treatment of depression in recent years and the suicide prevention in clinical care are very relevant. In Sweden, it has been found that education of general practitioners in the diagnosis and treatment of depression can reduce suicide rates. Epidemiological data show that antidepressants reduce the risk of suicide in patients with depression. A sufficient therapeutic dose of the drug should last for several months. For the elderly, treatment should continue for two years after the symptoms have recovered. In the case of regular use of lithium maintenance therapy, it was found that there was a lower risk of suicide.

Alcoholism

 Alcoholism (including alcohol abuse and alcohol dependence) is a common diagnosis among suicide groups, especially among young people. The association between suicide and alcoholism has physical, psychological, and social explanations. Among alcoholics, there are specific factors that increase the risk of suicide:

Early onset alcoholism

Long-term drinking

High dependence

Melancholy mood

Poor health

Poor job performance

Disordered personal life

Have a family history of alcoholism

There has been a recent major breakdown or loss of interpersonal relationships (eg separation of spouse/family members, divorce, death)

Schizophrenia

    Schizophrenia is characterized by confusion in speech, thought, hearing or vision, personal hygiene, and social behavior; in short, it results in drastic changes in behavior and/or feeling, or strange thoughts.

Suicide is the leading cause of premature death of patients with schizophrenia. People with schizophrenia are at higher risk of suicide when they have the following characteristics:

Unemployed young single men

Early disease

Recent relapse

Fear of worsening symptoms, especially for patients with high intelligence (high education)

Positive symptoms of paranoia and delusion

Depression symptoms

The risk of suicide is highest at the following moments:

Early in the disease, when the patient is in confusion and/or confusion

In the early stages of relapse, when patients think they have overcome the disease but relapse

In the early stages of recovery, when symptoms seem to have improved but the patient feels vulnerable inside

Within a short time of discharge

Suicide risk decreases with time of illness

Personality disorders

 Recent studies have found that the prevalence of personality disorders is higher in the young people who die by suicide (20-50%). Among the ethnic groups with personality disorders, borderline personality disorders and antisocial personality disorders are more related to suicide.

 Dramatic personality disorders, narcissistic personality disorders, and specific psychological traits, such as impulsivity and aggressiveness, are also related to suicide.

Anxiety Disorders

 Among anxiety disorders, panic disorder and suicide have the highest correlation, followed by obsessive-compulsive disorders. Physical disorders and eating disorders (anorexia psychogenic and binge eating disorder) are also related to suicidal behavior.

Suicide and physical illness

　　The risk of suicide is higher in the group with chronic physical diseases. In addition, a relatively high percentage of people with physical disorders have mental disorders, especially depression. Chronic diseases, disability, and poor recovery are all related to suicide.