Diagnostik und Therapie von Suizidalität im Jugendalter: Das Wichtigste in Kürze aus den aktuellen Leitlinien

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.

Suicidality in Childhood and Adolescence

“…Schools have paramount importance as the place for programs to prevent suicide in childhood and adolescence (6). A successful example was provided by the school-based European Union (EU) project "Saving and Empowering Young Lives in Europe" (SEYLE) (e23), which was tested in 11 000 schools across 10 EU countries.…”

Emergency Presentations to Child and Adolescent Psychiatry: Nonsuicidal Self-Injury and Suicidality

“…The German clincial guidelines for NSSI and for suicidality in youth recommend assessments for acute suiciality by a child and adolescent psychotherapist or a specialist for child and adolescent psychiatry both in patients presenting with NSSI, as well as in patients with suicidality (7,8). Therefore, children and adolescents, who report NSSI and suicidality often present themselves to child and adolescents psychiatric emergency services as a first contact to the mental health system.…”

Notfälle und Krisen bei Kindern und Jugendlichen – was ist eigentlich normal?

“…Mit diesem Vorgehen wird eingeschätzt, welche Risikofaktoren sich verringern und positiv beeinflussen lassen und welche protektiven Faktoren gestärkt und eingesetzt werden können, um die Krisensituation in einem möglichst kurzen Zeitraum zu beenden [7] [8].…”