36例の自殺未遂者の実態調査および明確な精神疾患に該当しなかった2例の自殺未遂症例について

Two Cases of Suicidal Persons not Diagnosed with Psychiatric Illness

抄録

　当科へ入院した36例の自殺未遂患者のうち，ICD-10の特定のFコードに該当しなかった2例について，1)中年の男性，2)責任感が強い，3)問題が生じた時に他者に相談する習慣を持っていない，4)自殺企図の既往がない，という共通の特徴を認めた。2例とも自殺企図直後は希死念慮以外の明らかな精神症状を認めなかったが，Shneidmanの言う心理的視野狭窄状態に陥っており，実際の治療的かかわりが有用であった。精神疾患は自殺の大きなリスクファクターと考えられているが，本報告の2症例は精神疾患の併発がなくても重篤な自殺企図に至っており，精神疾患以外の自殺の成因を探る上で重要な症例と考えられた。

　We reported two cases of suicidal persons who had not been diagnosed with any psychiatric illness and shared common features, for example, both were middle-aged men, had a strong sense of responsibility, had not been consulting anyone else, and had no history of suicide attempt. Though both persons showed no psychological symptoms other than suicidal ideation after the suicide attempt, they were believed to experience psychological constriction for which they received treatment. Though mental illness is considered a major risk factor for suicide, the two cases with no prior psychiatric diagnosis explained the contributing factors of suicide besides mental illness.