When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

自杀风险管理

Last reviewed: 13 Feb 2025
Last updated: 08 Dec 2020

Summary

Definition

History and exam

Key diagnostic factors

  • 既往有自杀企图或自我伤害事件
  • 当前自杀计划
  • 获得致命方法的途径
  • 精神疾病病史,包括物质滥用/误用
  • 自杀或精神病家族史
Full details

Other diagnostic factors

  • 慢性躯体疾病、残疾或毁容
  • 显著社会心理因素
  • 无用性特质
Full details

Risk factors

  • 当前自杀计划
  • 自我伤害
  • 精神病既往史,包括物质滥用
  • 致命方法的可用性
  • 童年期受虐待或忽视史
  • 自杀死亡家族史
  • 男性
  • 囚犯
  • 精神疾病家族史
  • 躯体疾病
  • 婚姻状况(离婚、单身、丧偶)
  • 行业/职业(失业者、个体经营者、农业劳动者、医疗和牙科专业人员)
  • 社会心理应激源
Full details

Diagnostic investigations

1st investigations to order

  • 临床诊断
Full details

Treatment algorithm

ACUTE

可能会进行自我伤害或自杀的患者

ONGOING

自杀死亡者遗族

Contributors

Authors

Alys Cole-King, MB, BCh, DGM, MSc, FRCPsych

Consultant Liaison Psychiatrist

Liaison Team

Glan Clwyd Hospital

Betsi Cadwaladr Health Board

St Asaph

Wales

UK

Disclosures

ACK is an employee and director of 4Mental Health and, in this capacity, has received funding for designing and delivering training. ACK is an author of references cited in this topic.

Angharad de Cates, BMBCh, BA Hons (Oxon), MSc (Warw), MRCPsych

Wellcome Trust Clinical Doctoral Fellow

Department of Psychiatry

University of Oxford

Warneford Hospital

Honorary Clinical Fellow

Oxford Health NHS Foundation Trust

Oxford

UK 

Disclosures

AdeC is in receipt of a clinical doctoral training fellowship from the Wellcome Trust (since October 2018) and a travel fellowship from the Royal College of Psychiatrists/Gatsby Foundation. All are external bodies that fund research into and/or release information that includes suicide prevention. 

Acknowledgements

Dr Alys Cole-King and Dr Angharad de Cates would like to gratefully acknowledge Dr Stan Kutcher and Dr Magdalena Szumilas, previous contributors to this topic.

Disclosures

SK has received research grants from various foundations and national granting agencies (none from either the pharmaceutical nor psychotherapy industries) to support some of his academic work. He is employed by a university and hospital, and sees patients who sometimes present with a suicide attempt. He has also co-authored a textbook on suicide risk assessment and management, published in 2007 and the second edition in 2012. MS is an author of a reference cited in this topic.

Peer reviewers

Stephen Platt, BA, MSc, PhD

Emeritus Professor of Health Policy Research

University of Edinburgh

Edinburgh

Scotland

UK

Disclosures

SP is a paid consultant to Samaritans, NHS Health Scotland, the Scottish Government, and the Irish National Office of Suicide Prevention. He is an unpaid adviser to The Listening Place.

Steve Gilbert, BSc Sports & Materials Science

Patient Advocate

Sports & Materials Science

University of Birmingham

Birmingham

UK

Disclosures

SG is the vice-chair of the Independent Mental Health Act Review; an associate trainer for suicide mitigation at Connecting with People; Programme Lead for the Engager Prison Project; trustee for the Council of Management for Mind and the Association of Mental Health Providers; Service User Representative for West Midlands Mental Health (STP) Alliance; occasional advisor to the National Suicide Prevention Alliance and Public Health England; and a member of the West Midlands Service User Representative Forum, Royal College of Psychiatrists West Midlands Executive Division. He receives a salary and/or travel and subsistence expenses for these roles.

  • Differentials

    • 自伤
    More Differentials
  • Guidelines

    • 在社区和看守所预防自杀
    • 双相情感障碍:评估和管理
    More Guidelines
  • Patient information

    Suicide risk management

    Anxiety: what treatments work?

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer