Der Nervenarzt
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Suicidality represents a frequent phenomenon in affective and psychotic disorders but the treatment of acute and chronic suicidality is still a controversial issue. Especially the efficacy of antidepressant and neuroleptic drugs for prevention of suicide continues to be debated. There is a lack of evidence due to limitations of methodological studies and ethical concerns are a major issue. ⋯ Considering the frequent occurrence of suicidality the currently available evidence is undoubtedly insufficient. The improvement of study concepts and especially a more differentiated consideration of the vague term "suicidality" seems to be essential. An underrepresentation of the evidence-based therapeutic options with lithium and clozapine in the treatment of suicidal patients needs to be avoided.
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Although in recent years many efforts have been made in suicide prevention, suicidal ideation in prison is still a major problem. The present study is part of a project being carried out in Saxony, Germany on the investigation and prevention of suicide in prisons. ⋯ Although there were some limitations, this study could confirm data in the literature that personality disorders are associated with an increased risk of suicidal ideation in prisoners. The lack of association of suicidal thoughts as measured in this study with the total time spent in prison and duration of imprisonment is in contradiction to the results of other studies and warrants further investigation.
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Suicidal thoughts and behavior have been a part of human nature since the beginning of mankind. In his autobiographical work From my Life: Poetry and Truth Goethe summarized two important aspects: "Suicide is an event of human nature which, whatever may be said and done with respect to it, demands the sympathy of every man, and in every epoch must be discussed anew". The authors of this article aim to motivate the readership to question and analyze this complex topic and the accompanying multifaceted positions with a summarized presentation of historical aspects and the more recent political developments.