[Psychopathology and psychodynamics of self destruction]

Abstract

Starting from the first publications on the topic as e.g. the famous monograph "Le suicide" written by Durkheim in 1897, the suicide research was based mainly on psychosocial dimensions. Therefore, the main area of research were patients who had survived an attempt of suicide. This led to the faulty conclusion that these patients represent the largest risk group. Today we know that depressive patients represent the number one risk group. They are followed by drug and alcohol addicts, by elderly and lonesome people, by the group of patients who threaten with suicide or who announce it, and finally as a last risk group, by those people who have failed at a first attempt. The psychodynamics show that suicidal behavior is akin to self-aggression. Mainly among younger people occur suicides, which have predominantly the function to appeal, to draw attention to the subject who has been unable to verbalize his problems. One attempt to help these people consists of becoming aware that the wish to die generally goes along with the wish to stay alive, from which result the cries for help and announcements of suicide. Apart from this psychosocial suicide research, in recent years a biological component turned out to be possibly more relevant than originally assumed. With respect to the heredity of suicidal behavior up to now only those suicidal acts were considered that occur within the frame of endogenous depressions. Recent studies however point at an accumulation within families that is not in context with the manic-depressive illness. Biochemical studies indicate in addition that suicidal behavior tends to go along frequently with a lack of serotonin. From this follows that inthe future suicide and suicide treatment will see a biopsychosocial theory as a basis.