psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2023-21-6-58-74psychiatry-1069Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSСуицидальное поведение в контексте посттравматического стрессового расстройства — психиатрические и психосоциальные аспектыSuicidal Behavior in the Context of Post-Traumatic Stress Disorder — Psychiatric and Psychosocial Aspectshttps://orcid.org/0000-0002-9641-7120РозановВ. А.RozanovV. A.

Всеволод Анатольевич Розанов, доктор медицинских наук, профессор, главный научный сотрудник

факультет психологии

кафедра психологии здоровья и отклоняющегося поведения

отделение лечения пограничных психических расстройств и психотерапии

Санкт-Петербург

Vsevolod A. Rozanov, Dr. of Sci. (Med.), Professor, Chief Scientist

Department of Psychology

Department of Health Psychology and Deviant Behaviours

Department for the Treatment of Borderline Mental Disorders and Psychotherapy

St. Petersburg

v.rozanov@spbu.ruhttps://orcid.org/0000-0002-8798-3702КараваеваТ. А.KaravaevaT. A.

Татьяна Артуровна Караваева, доктор медицинских наук, главный научный сотрудник, руководитель отделения, профессор, профессор кафедры, ведущий научный сотрудник

отделение лечения пограничных психических расстройств и психотерапии

кафедра медицинской психологии и психофизиологии

кафедра общей и прикладной психологии с курсами медико-биологических дисциплин и педагогики

научный отдел инновационных методов терапевтической онкологии и реабилитации

Санкт-Петербург

Tatiana A. Karavaeva, Dr. of Sci. (Med.), Chief Scientist, Head of the Department, Professor, Professor at the Chair, Leading Researcher

Department for the Treatment of Borderline Mental Disorders and Psychotherapy

Chair of Medical Psychology and Psychophysiology

Chair of General and Applied Psychology with courses in biomedical disciplines and pedagogy

Scientific Department of Innovative Methods of Therapeutic Oncology and Rehabilitation

St. Petersburg

tania_kar@mail.ruhttps://orcid.org/0000-0002-5116-836XВасильеваА. В.VasilevaA. V.

Анна Владимировна Васильева, доктор медицинских наук, главный научный сотрудник, профессор

отделение лечения пограничных психических расстройств и психотерапии

кафедра психотерапии и сексологии

Санкт-Петербург

Anna V. Vasileva, Dr. of Sci. (Med.), Chief Scientist, Professor

Department for the Treatment of Borderline Mental Disorders and Psychotherapy

Chair of Psychotherapy and Sexology

St. Petersburg

annavdoc@yahoo.comhttps://orcid.org/0000-0001-9020-3271РадионовД. С.RadionovD. S.

Дмитрий Сергеевич Радионов, младший научный cотрудник

отделение лечения пограничных психических расстройств и психотерапии

Санкт-Петербург

Dmitriy S. Radionov, Junior Researcher

Department for Treatment of Borderline Mental Disorders and Psychotherapy

St. Petersburg

dumradik@mail.ruФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава России; ФГБОУ ВО «Санкт-Петербургский государственный университет»РоссияV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology; Saint Petersburg State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава России; ФГБОУ ВО «Санкт-Петербургский государственный университет»; ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России; ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава РоссииРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology; Saint Petersburg State University; Saint Petersburg State Pediatric Medical University; National Medical Research Center of Oncology Named after N.N. PetrovRussian FederationФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава России; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and Neurology; I.I. Mechnikov North-western Medical State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава РоссииРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian Federation2023030120242165874Copyright © Розанов В.А., Караваева Т.А., Васильева А.В., Радионов Д.С., 20242024Розанов В.А., Караваева Т.А., Васильева А.В., Радионов Д.С.Rozanov V.A., Karavaeva T.A., Vasileva A.V., Radionov D.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/1069   Обоснование

   Обоснование: стресс и травма играют важную роль в патогенезе ПТСР и суицида, однако суицидальное поведение при ПТСР охарактеризовано недостаточно.

   Цель описательного обзора — представить новейшие и наиболее доказательные данные о связи суицидального поведения (под которым понимается широкий спектр проявлений — от суицидальных мыслей и попыток до завершенного суицида) с психиатрическим диагнозом ПТСР, либо с отдельными симптомами этого расстройства у разных контингентов.

   Материал и методы

   Материал и методы: поиск информации осуществлялся в базах данных PubMed и eLibrary, а также в монографических изданиях, с учетом степени доказательности.

   Результаты

   Результаты: имеющиеся данные убедительно свидетельствуют о том, что ПТСР является не приоритетным, но существенным фактором повышенного риска суицида, особенно в сочетании с депрессией и аддикциями. Чем в большей степени тот или иной контингент подвержен травматическому стрессу, тем сильнее проявляется связь между симптомами ПТСР и суицидальным поведением. Влияние ПТСР на суицидальность в значительной степени опосредовано коморбидностью и выраженностью психосоциальной дезадаптации, которая часто сопутствует ПТСР. Зависимость от травмирующего события и стресс-уязвимость выступают общими звеньями патогенеза ПТСР, депрессии и суицида.

   Заключение

   Заключение: в клинической практике наличие диагноза или признаков ПТСР является основанием для более пристального внимания к суицидальным тенденциям пациента и адресного использования мер превенции. На популяционном уровне необходимо стремиться к укреплению общей жизнестойкости и стрессоустойчивости населения.

   Background

   Background: stress and trauma are important both for the development of PTSD and suicide, however, suicidal behavior in PTSD is not characterized enough.

   The aim of this narrative review is to present the latest and most evidence-based data on the relationship between suicidal behavior (in its wide range of manifestations — from suicidal thoughts and attempts to completedsuicide) with a psychiatric diagnosis of PTSD, or with individual symptoms of this disorder in different contingents.

   Materials and methods

   Materials and methods: data search was performed in PubMed and e-Library, as well as in relevant monographs, mostly evidence-based sources.

   Results

   Results: the data available strongly suggest that PTSD is not a priority, but a significant factor in an increased risk of suicide, especially in case of comorbidity with depression and addictions. The more a particular group is exposed to traumatic stress, the stronger the relationship between PTSD symptoms and suicidal behavior. The impact of PTSD on suicidality is largely mediated by the comorbidity and severity of psychosocial maladjustment that often accompanies PTSD. Dependence on a traumatic event and stress vulnerability are common links in the pathogenesis of PTSD, depression, and suicide.

   Conclusion

   Conclusion: in clinical practice, the presence of a diagnosis or selected symptoms of PTSD is the reason for closer attention to the suicidal tendencies of the patient and the use of targeted prevention measures. On the population level, it is necessary to pay more attention to general hardiness and stress resilience.

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The authors declare that there are no conflicts of interest present.