失智症患者的致命性自殺企圖與自殺防治－個案報告與文獻探討

失智症與自殺防治是老年精神醫學領域的兩大重要課題，然過去探討失智症與自殺的關聯性研究結論各異。隨著人口老化，失智症患者人口快速增加，可能使得失智老年人自殺人數增加，對國家醫療花費、失智者的照顧帶來重大負擔，探討可行的失智症自殺防治策略，顯得相當迫切且重要。本個案報告呈現一位82歲男性，在79歲時即確診失智，三年後喝農藥企圖自殺的治療過程，經深入探討其自殺企圖的生理和心理社會危險因子，並回顧最新相關失智者自殺之文獻後，發現失智症的神經精神症狀、共病憂鬱、不同病因類型的失智診斷等，可作為預防失智症患者自殺行為的介入目標。最後整合現有研究實證，提出失智症患者自殺之指標性、選擇性與全面性防治策略的重點綱要。

關鍵字

失智症；自殺危險因子；自殺防治

並列摘要

The association between dementia and suicide attempt is a critical issue in geriatric mental health, yet existing studies have reported conflicting findings. As the population ages, the number of patients with dementia has been increasing rapidly. Suicide attempts in this subpopulation also appear to rise, causing drastic impacts on affected individuals and their families and posing considerable burdens on national medical cost. There is accordingly an urgent need to develop effective suicide prevention strategies for patients with dementia. We present a case of suicide attempt in an 82-year-old man diagnosed of dementia 3 years ahead of the attempt. We aim to better elucidate the association between dementia and risk factors of suicide based on clinical assessment and thorough literature review. Neuropsychiatric symptoms of dementia, depression in dementia, and dementia etiology are examined and previous studies reviewed to help propose potentially effective strategies for suicide prevention in patients with dementia.

並列關鍵字

dementia ； risk factor of suicide ； suicide prevention

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