[Assessment and therapy of suicidality in adolescence: the most important recommendations of the current guideline]

Z Kinder Jugendpsychiatr Psychother. 2017 Nov;45(6):485-497. doi: 10.1024/1422-4917/a000516. Epub 2017 Mar 10.
[Article in German]

Abstract

Due to the clinical relevance of suicidal risks, suicide attempts, and suicides in adolescence consensus-based guidelines with clinical recommendations were updated and summarized in this article. It should be considered that each indication has to be taken serious. Suicidality is an essential component of the psychopathological report and should be explored for the short- and long term risk. The clinical assessment of the acute suicidality results from a trustful anamnestic conversation, assessment of risk factors, mental disorders, and the use of alcohol and drugs. Acute suicidality is an indication for an inpatient treatment that for the protection of the patient has to be implemented also against his will. An adequate documentation is inevitable. After a suicide attempt, in addition to the initial medical treatment it has to be paid attention that the patient cannot harm himself any further and a rapid consultation in the responsible clinic takes place. First therapeutic goal is the reduction of suicidality and if necessary the re-achievement of the ability to negotiate a non-suicide agreement. For recurrent suicide thoughts an emergency plan has to be created. In addition to offer conversations, for a further relief a temporary sedated psychopharmacology can be necessary. In case of a suicide in a clinic, recommendations should be present that regulates responsibilities and procedures. Effective prevention methods are multiplier training, public education, restricted access to methods, and complying with media guidelines.

Keywords: guidelines; postvention; suicidal behavior disorder; suicidal ideation; suicidality.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Algorithms
  • Ambulatory Care
  • Child
  • Combined Modality Therapy
  • Cross-Sectional Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Guideline Adherence*
  • Humans
  • International Classification of Diseases
  • Male
  • Patient Admission
  • Psychotherapy
  • Risk Factors
  • Self-Injurious Behavior / classification
  • Self-Injurious Behavior / diagnosis
  • Self-Injurious Behavior / prevention & control*
  • Self-Injurious Behavior / psychology*
  • Suicidal Ideation*
  • Suicide / classification
  • Suicide / prevention & control*
  • Suicide / psychology*
  • Suicide / statistics & numerical data
  • Suicide, Attempted / classification
  • Suicide, Attempted / prevention & control*
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / statistics & numerical data