自杀风险的评估：基于诊断的视角

doi:10.3724/SP.J.1042.2025.0494

摘要/Abstract

摘要：

自杀风险的评估是干预的前提和基础, 但其标准化和准确性一直是自杀领域面临的主要挑战。近年来, 越来越多的研究表明自杀并非仅限于某些特定精神障碍的诊断范畴, 而是一种跨诊断的临床综合征。因此, 设置单独的自杀诊断以改进临床自杀风险的评估成为了新的研究方向, 已形成的自杀行为障碍、自杀危机综合征和急性自杀情感障碍等诊断方案在实证研究和临床应用上也取得了进展。然而, 现有的诊断方案仍不成熟, 其实际应用也存在潜在的风险。未来需要从内涵界定、诊断鉴别和研究设计等方面进行完善和验证。

关键词: 自杀, 精神障碍, 评估, 预测, 自杀诊断

Abstract:

Suicide risk assessment is fundamental to effective intervention, but its standardization and accuracy have been a major challenge for the field of suicide. Recent research on the relationship between suicide and mental disorders has found that suicide is not limited to the diagnostic of some specific mental disorders, but is a transdiagnostic clinical syndrome. As a result, the field of suicide has begun to explore the possibility of setting a suicide-specific diagnosis to improve suicide risk assessment. Diagnostic models, such as suicidal behavior disorder, suicidal crisis syndrome and acute suicidal affective disorder, have shown promising advances in empirical research and clinical application. However, these diagnostic approaches remain underdeveloped and carry potential risks in practical application. Future efforts should focus on refining and validating these models by clarifying conceptual definitions, improving diagnostic differentiation, enhancing research design, and developing assessment tools.

Key words: suicide, mental disorders, assessment, prediction, suicide-specific diagnosis

中图分类号:

R395

侯祥庆, 杨盈, 张倩倩, 杨丽. (2025). 自杀风险的评估：基于诊断的视角. 心理科学进展 , 33(3), 494-505.

HOU Xiangqing, YANG Ying, ZHANG Qianqian, YANG Li. (2025). Suicide risk assessment: A diagnostic perspective. Advances in Psychological Science, 33(3), 494-505.

图/表 4

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	ICD-11		DSM-5
诊断	双相及相关障碍	抑郁障碍	双相及相关障碍	抑郁障碍	人格障碍
亚型	双相障碍I型双相障碍II型	单次发作抑郁障碍复发发作抑郁障碍	双相I型障碍双相II型障碍	重性抑郁障碍	边缘型人格障碍
描述	反复出现死亡或自杀的念头		反复出现死亡的想法(而不仅仅是恐惧死亡), 反复出现没有具体计划的自杀观念, 或有某种自杀企图, 或有某种实施自杀的具体计划。		反复发生自杀行为、自杀姿态或威胁, 或自残行为。

	ICD-11		DSM-5
诊断	双相及相关障碍	抑郁障碍	双相及相关障碍	抑郁障碍	人格障碍
亚型	双相障碍I型双相障碍II型	单次发作抑郁障碍复发发作抑郁障碍	双相I型障碍双相II型障碍	重性抑郁障碍	边缘型人格障碍
描述	反复出现死亡或自杀的念头		反复出现死亡的想法(而不仅仅是恐惧死亡), 反复出现没有具体计划的自杀观念, 或有某种自杀企图, 或有某种实施自杀的具体计划。		反复发生自杀行为、自杀姿态或威胁, 或自残行为。