Advances in Psychological Science ›› 2025, Vol. 33 ›› Issue (3): 494-505.doi: 10.3724/SP.J.1042.2025.0494
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HOU Xiangqing1,2,3, YANG Ying2,3, ZHANG Qianqian1,2,3, YANG Li2,3()
Received:
2024-01-16
Online:
2025-03-15
Published:
2025-01-24
CLC Number:
HOU Xiangqing, YANG Ying, ZHANG Qianqian, YANG Li. Suicide risk assessment: A diagnostic perspective[J]. Advances in Psychological Science, 2025, 33(3): 494-505.
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。 |
A:在过去的24个月内, 个体有过自杀尝试 B:不符合非自杀性自伤的标准, 即不以缓解负面情绪/认知状态或为实现积极情绪状态为目的而实施的针对身体表面的自我伤害 C:该诊断不适用于自杀意念或准备行为 D:不是在谵妄或精神错乱状态下实施的 E:不纯粹出于政治或宗教目的 |
A:在过去的24个月内, 个体有过自杀尝试 B:不符合非自杀性自伤的标准, 即不以缓解负面情绪/认知状态或为实现积极情绪状态为目的而实施的针对身体表面的自我伤害 C:该诊断不适用于自杀意念或准备行为 D:不是在谵妄或精神错乱状态下实施的 E:不纯粹出于政治或宗教目的 |
A:困境感(在感到无法忍受和无法逃离的处境中,仍然想要逃离的急迫感) B:相关问题 a情绪紊乱(至少表现为以下一项) 情绪急剧波动(短时间内负面情绪快速飙升或情绪强烈波动) 极度焦虑(极度担心、烦躁以及灾难化的预期, 可能伴有解离或感觉障碍) 急性快感缺失(首发的或加剧的无法体验到或预期到兴趣或快乐) 心理痛苦(强烈的不愉快的负面情绪, 其特点是痛苦、破碎和受伤的感觉) b认知失控(至少表现为以下一项) 反刍(强烈或持续地思考自己的痛苦和导致痛苦的原因) 认知僵化(无法偏离重复的消极思维模式, 否定任何除了自杀以外的可能的解决方案) 想法抑制失败(反复试图抑制消极的或令人不安的想法, 但总是失败) 反刍泛滥(更强烈的反刍形式, 一种负面想法压倒性泛滥的体验, 伴有头部压力或疼痛) c过度唤醒(至少表现为以下一项) 激越(感到不安或紧张) 过度警惕(对潜在危险的感知和敏感性的增加) 易激惹(对一般甚至轻微刺激的过度情感反应, 如烦恼、急躁、愤怒等) 失眠(难以入睡和/或保持睡眠) d社会退缩(至少表现为以下一项) 社会隔离(退出或缩小社会活动范围) 沟通回避(避免与亲近的人接触) |
A:困境感(在感到无法忍受和无法逃离的处境中,仍然想要逃离的急迫感) B:相关问题 a情绪紊乱(至少表现为以下一项) 情绪急剧波动(短时间内负面情绪快速飙升或情绪强烈波动) 极度焦虑(极度担心、烦躁以及灾难化的预期, 可能伴有解离或感觉障碍) 急性快感缺失(首发的或加剧的无法体验到或预期到兴趣或快乐) 心理痛苦(强烈的不愉快的负面情绪, 其特点是痛苦、破碎和受伤的感觉) b认知失控(至少表现为以下一项) 反刍(强烈或持续地思考自己的痛苦和导致痛苦的原因) 认知僵化(无法偏离重复的消极思维模式, 否定任何除了自杀以外的可能的解决方案) 想法抑制失败(反复试图抑制消极的或令人不安的想法, 但总是失败) 反刍泛滥(更强烈的反刍形式, 一种负面想法压倒性泛滥的体验, 伴有头部压力或疼痛) c过度唤醒(至少表现为以下一项) 激越(感到不安或紧张) 过度警惕(对潜在危险的感知和敏感性的增加) 易激惹(对一般甚至轻微刺激的过度情感反应, 如烦恼、急躁、愤怒等) 失眠(难以入睡和/或保持睡眠) d社会退缩(至少表现为以下一项) 社会隔离(退出或缩小社会活动范围) 沟通回避(避免与亲近的人接触) |
A:数小时或数天内(而非数周或数月内)自杀意图的急剧增加 |
B:明显的社会隔离(如社会退缩、厌恶他人、认为自己是他人的负担)和/或自我隔离(如自我厌恶、认为自己的心理痛苦是一种负担) |
C:认为自杀意图(A)和社会隔离/自我隔离(B)状况是没有希望改变的 |
D:具有两种或两种以上过度唤醒的症状(如激越、易激惹、失眠、噩梦) |
A:数小时或数天内(而非数周或数月内)自杀意图的急剧增加 |
B:明显的社会隔离(如社会退缩、厌恶他人、认为自己是他人的负担)和/或自我隔离(如自我厌恶、认为自己的心理痛苦是一种负担) |
C:认为自杀意图(A)和社会隔离/自我隔离(B)状况是没有希望改变的 |
D:具有两种或两种以上过度唤醒的症状(如激越、易激惹、失眠、噩梦) |
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