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Abstract

第124巻第5号

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Prevention of Suicide Reattempts among Children and Adolescents: Consideration based on the Risk and Protective Factors
Katsunaka MIKAMI
Department of Psychiatry, Tokai University School of Medicine
Psychiatria et Neurologia Japonica 124: 330-339, 2022

 A history of a prior suicide attempt is one of the greatest predictors of completed suicide. Clarification of the clinical characteristics of young suicide attempters will therefore facilitate the development of preventive interventions for suicide reattempts, which will in turn reduce the number of completed suicides. This review focused on therapeutic interventions aimed at preventing suicide reattempts in children and adolescents, based on risk and protective factors.
 Suicide attempters are normally transported to Emergency Departments (EDs) in hospitals. The medical interventions at EDs can be an opportunity to provide mental health care and prevent suicide reattempts among children and adolescents.
 It is important to reduce risk factors and strengthen protective factors to prevent suicide reattempts. Among these risk factors, there are only a limited number of factors that can be intervened upon. First, clinicians should prioritize the management of the life stressors that triggered the suicide attempt. Second, when family problems seem to be the psychosocial factors associated with suicide attempts, it is necessary to consider such problems not only as precipitating events, but also as long-standing psychosocial predisposing factors. In such cases, regardless of the psychiatric diagnosis or the need for medication, it would be preferable for clinicians to pay attention to each person's upbringing and understand the fact that the person may not have had much experience seeking help from those close to them since childhood. These may act as psychosocial predisposing factors responsible for suicide and interventions for suicide prevention should be provided after taking them into account. Finally, when interventions are provided for mental disorders with the aim of preventing suicide reattempts, clinicians should keep in mind the presence of autism spectrum disorder in suicide attempters.
 School and home can be protective factors for suicide if young individuals can experience a sense of belonging to each of these places. The young individuals will have a sense of belonging to their families when the family members are emotionally attached to each other. Clinicians need to provide interventions for the psychosocial predisposing factors of each individual accordingly. Thus, this intervention will contribute not only to reducing risk factors but also to strengthening protective factors for suicide reattempts. In addition, clinicians need to establish strong partnerships with community facilities. Such collaboration will lead to the strengthening of protective factors by ensuring that the youth feel safe.
 Author's abstract

Keywords:children and adolescents, suicide reattempt prevention, risk factor, protective factor, psychosocial predisposing factor for suicide>
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