Dergi Ara >>
Yıl:2016; Cilt: 9; Sayı: 3>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2016;9(3):62-70
İntiharda Risk Değerlendirmesi
D Gündoğar, İM Atay
Süleyman Demirel Üniversitesi, Isparta
İntihar dünyadaki en önemli ölüm ve yeti kaybı sebepleri arasında yer alır ve bu nedenle küresel halk sağlığı sorunlarından birini oluşturur. Tüm dünyadaki ölüm sebepleri arasında on beşinci sırada yer alır. İntiharda uygun risk değerlendirmesi bilinen risk faktörleri temelinde yapılmalıdır. İntiharda risk değerlendirmesi beş aşamada gerçekleştirilir: Kimlerin kapsamlı biçimde değerlendirileceğinin belirlenmesi, uyarıcı bulguların tanımlanması, koruyucu faktörleri ve risk faktörlerini belirlemek, müdahale planını oluşturmak. İntihar riskini değerlendirmede faydalanılabilecek çeşitli ölçekler vardır. En doğru yaklaşım ise klinik görüşme ve ölçeklerden birlikte faydalanmaktır. Risk değerlendirmesi terapötik işbirliği, tetikleyici faktörlerin tanımlanması, intihar düşüncelerinin belirlenmesi, risk faktörleri ve koruyucu faktörlerin tanımlanması, ayrıntılı ruhsal ve davranışsal durum muayenesini gerektiren ve ustalık isteyen bir yaklaşımdır. Bu nedenle bütün hastalarda yapılandırılmış bir çerçeveyle görüşme yapılması risk değerlendirmesinin daha güvenilir biçimde yapılmasını sağlayabilir. Sadece ruh sağlığı çalışanlarına değil, birinci basamaktaki sağlık personeline de intiharda risk değerlendirmesi eğitimi verilmeli ve güncel bilgiler ışığında tekrarlanmalıdır.
Risk assessment; suicide; risk factors; suicidal ideation
Suicide is among the most important causes of disability and death in the world and thus should be considered as an important public health problem. It constitutes the 15th most common cause of mortality. Apropriate risk evaluation in suicide is accomplished in view of the known risk faktors. Risk evaluation is performed through five steps: Identifying whom to be screened in detail, identifying the warning signs, determining the protective and risk factors, to make the intervention plan. There are various scales that can be helpful for evaluating suicide risk. The most useful approach is to apply clinical interview and scales together. Risk evaluation requires therapeutic alliance, determination of the risk factors and protective factors, detailed mental and behavioral examination and should be carried out with expertise. Interviewing these patients with a structured framework may be helpful for a more reliable risk evaluation. Not only mental health personnel but also primary care workers should receive suicide risk evaluation education with periodic updates.

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