The relationship between suicide and dementia has not systematically been investigated, although the prevalence of both, dementia and suicide, increases with age. In contrast to patients with other psychiatric disorders, patients with dementia were not found to die from suicide more often than expected (SMR, 0). Thus the diagnosis of dementia does not contribute to the elevated suicide risk in old age. In studies using the psychological autopsy method, dementia was rarely diagnosed in suicide victims. Suicide attempts were observed in less than 1% of all patients with dementia. Depression as an important common risk factor of suicide and dementia is often found in patients with Alzheimer's disease (0% to 86%) as well as in patients with multi-infarct dementia (20% to 45%). However major depression was found significantly more often in vascular dementia than in dementia of Alzheimer type. Suicidal thoughts and intents, wishes to die and feelings that life is not worth living were reported in 1% to 42% of all patients with dementia, especially if these patients also suffered from depression. This review comprehensively presents the association between cognitive deficits, insight in early stages of dementia and suicidality and possible confounders which have not systematically been investigated up to now.

译文

自杀和痴呆之间的关系尚未得到系统的调查,尽管痴呆和自杀的患病率随着年龄的增长而增加。与患有其他精神疾病的患者相比,未发现痴呆症患者死于自杀的频率高于预期 (SMR,0)。因此,痴呆症的诊断不会导致老年自杀风险升高。在使用心理尸检方法的研究中,很少在自杀受害者中诊断出痴呆症。在所有痴呆症患者中,只有不到1% 的人观察到自杀未遂。抑郁症是自杀和痴呆的重要常见危险因素,通常在阿尔茨海默氏病患者 (0% 至86%) 以及多梗塞性痴呆患者 (20% 至45%) 中发现。然而,在血管性痴呆中发现的重度抑郁症比在阿尔茨海默型痴呆中发现的更多。1% 所有痴呆症患者的42%,自杀的想法和意图,希望死亡和生活不值得生活的感觉,特别是如果这些患者也患有抑郁症。这篇综述全面介绍了认知缺陷,痴呆症早期阶段的洞察力和自杀倾向与可能的混杂因素之间的关联,到目前为止尚未系统地进行研究。

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