The association of depression with an increased risk of suicide is well known.Suicides are committed within 15% of patients. In the last decade, the frequency of suicides has sharply increased. Patients with depression make up 32-47% of those who commit suicide. Among them, there are 2-4 times more men than women. The most common method of suicide is poisoning.
Suicidal risk is higher in psychotic and anxiety depressions, as well as in mixed states, with a combination of depressed mood with a sense of hopelessness, restlessness and impulsivity.
Of great importance in the formation of suicidal tendencies is social and domestic factors, the relationship with the environment. Depressive patients who commit suicide are most often lonely people who maintain only formal interpersonal contacts. Not often the formation of suicidal behavior is preceded by the death of relatives or conflicts in the family.
Along with depression, one of the main factors of suicidal risk, especially significant in the elderly, are chronic somatic diseases.
The first action of a general practitioner when a patient has thoughts of death, and even more so suicidal tendencies, is to immediately refer him to a psychiatrist. The doctor will need to recognize the clinical signs of suicidal behavior.
Particularly great difficulties appear with erased somatized, masked depressions, as well as with dysthymia. Some patients may hide suicidal thoughts for a long time, dissimulate. When questioning a sick person, the doctor should carefully clarify whether the patient feels that life has lost its meaning for him. Does he have a desire, going to bed in the evening, not to wake up in the morning. Is he contemplating suicide. Of great help in determining the risk of suicidal behavior can be data on suicides in the family and immediate environment of the sick person.