Skip to main content
Erschienen in: Der Nervenarzt 7/2018

16.11.2017 | Suizid | Übersichten

Stigma – Risikofaktor und Konsequenz suizidalen Verhaltens

Implikationen für die Suizidprävention

verfasst von: N. Oexle, N. Rüsch

Erschienen in: Der Nervenarzt | Ausgabe 7/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Psychische Erkrankung, vorheriges suizidales Verhalten und der Verlust eines Angehörigen durch Suizid gehören zu den stärksten Risikofaktoren für Suizid. Sowohl psychische Erkrankung als auch Suizidalität selbst sind stigmatisiert, was für Betroffene eine Belastung bedeutet, die zu suizidalen Gedanken und Handlungen beitragen kann. Viele Konsequenzen von Stigma, wie soziale Isolation, verringertes Selbstwertgefühl und Hoffnungslosigkeit, sind als Prädiktoren von Suizidalität bekannt. Maßnahmen zur Stigmareduktion könnten daher eine wichtige Komponente erfolgreicher Suizidprävention sein. Die vorliegende Arbeit erläutert den derzeitigen Forschungsstand zu dieser Hypothese. Eine Vielzahl von Studien bestätigt den Zusammenhang zwischen der Stigmatisierung psychischer Erkrankung und Suizidalität, und erste signifikante Ergebnisse über den Einfluss von Suizidstigma auf Suizidalität liegen vor. Dennoch wurde die Wirksamkeit bestehender Antistigma Interventionen zur Reduktion und Prävention von Suizidalität bisher nicht überprüft. Der Abbau von Stigma in der Allgemeinbevölkerung und unter Behandlern sowie Programme zur Unterstützung von Betroffenen im Umgang mit erlebter Stigmatisierung könnten wichtige Komponenten erfolgreicher Suizidprävention sein.
Literatur
2.
Zurück zum Zitat Calear AL, Batterham PJ, Christensen H (2014) Predictors of help-seeking for suicidal ideation in the community: risks and opportunities for public suicide prevention campaigns. Psychiatry Res 219:525–530CrossRefPubMed Calear AL, Batterham PJ, Christensen H (2014) Predictors of help-seeking for suicidal ideation in the community: risks and opportunities for public suicide prevention campaigns. Psychiatry Res 219:525–530CrossRefPubMed
4.
Zurück zum Zitat Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33:395–405CrossRefPubMed Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33:395–405CrossRefPubMed
5.
Zurück zum Zitat Clement S, Schauman O, Graham T et al (2015) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 45:11–27CrossRefPubMed Clement S, Schauman O, Graham T et al (2015) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 45:11–27CrossRefPubMed
6.
Zurück zum Zitat Corrigan PW, Larson JE, Michaels PJ et al (2015) Diminishing the self-stigma of mental illness by coming out proud. Psychiatry Res 229:148–154CrossRefPubMed Corrigan PW, Larson JE, Michaels PJ et al (2015) Diminishing the self-stigma of mental illness by coming out proud. Psychiatry Res 229:148–154CrossRefPubMed
7.
Zurück zum Zitat Dazzi T, Gribble R, Wessely S, Fear NT (2014) Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med 44:3361–3363CrossRefPubMed Dazzi T, Gribble R, Wessely S, Fear NT (2014) Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med 44:3361–3363CrossRefPubMed
8.
Zurück zum Zitat Dovidio JF, Gaertner SL (2010) Intergroup bias. In: Handb. Soc. Psychol, 5. Aufl. John Wiley & Sons, Hoboken Dovidio JF, Gaertner SL (2010) Intergroup bias. In: Handb. Soc. Psychol, 5. Aufl. John Wiley & Sons, Hoboken
9.
Zurück zum Zitat Dueweke AR, Bridges AJ (2017) The effects of brief, passive psychoeducation on suicide literacy, stigma, and attitudes toward help-seeking among Latino immigrants living in the United States. Stigma Health 2:28–42CrossRef Dueweke AR, Bridges AJ (2017) The effects of brief, passive psychoeducation on suicide literacy, stigma, and attitudes toward help-seeking among Latino immigrants living in the United States. Stigma Health 2:28–42CrossRef
10.
Zurück zum Zitat Farrelly S, Jeffery D, Rüsch N et al (2015) The link between mental health-related discrimination and suicidality: service user perspectives. Psychol Med 45:2013–2022CrossRefPubMed Farrelly S, Jeffery D, Rüsch N et al (2015) The link between mental health-related discrimination and suicidality: service user perspectives. Psychol Med 45:2013–2022CrossRefPubMed
11.
Zurück zum Zitat Feigelman W, Gorman BS, Jordan JR (2009) Stigmatization and suicide bereavement. Death Stud 33:591–608CrossRefPubMed Feigelman W, Gorman BS, Jordan JR (2009) Stigmatization and suicide bereavement. Death Stud 33:591–608CrossRefPubMed
12.
Zurück zum Zitat Fulginiti A, Pahwa R, Frey LM et al (2016) What factors influence the decision to share suicidal thoughts? A multilevel social network analysis of disclosure among individuals with serious mental illness. Suicide Life Threat Behav 46:398–412CrossRefPubMed Fulginiti A, Pahwa R, Frey LM et al (2016) What factors influence the decision to share suicidal thoughts? A multilevel social network analysis of disclosure among individuals with serious mental illness. Suicide Life Threat Behav 46:398–412CrossRefPubMed
13.
14.
Zurück zum Zitat Hanschmidt F, Lehnig F, Riedel-Heller SG, Kersting A (2016) The stigma of suicide survivorship and related consequences – A systematic review. PLOS ONE 11:e162688CrossRefPubMedPubMedCentral Hanschmidt F, Lehnig F, Riedel-Heller SG, Kersting A (2016) The stigma of suicide survivorship and related consequences – A systematic review. PLOS ONE 11:e162688CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Henderson C, Noblett J, Parke H et al (2014) Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry 1:467–482CrossRefPubMed Henderson C, Noblett J, Parke H et al (2014) Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry 1:467–482CrossRefPubMed
16.
Zurück zum Zitat Klonsky ED, May AM (2015) The Three-Step Theory (3ST): a new theory of suicide rooted in the “ideation-to-action” framework. Int J Cogn Ther 8:114–129CrossRef Klonsky ED, May AM (2015) The Three-Step Theory (3ST): a new theory of suicide rooted in the “ideation-to-action” framework. Int J Cogn Ther 8:114–129CrossRef
17.
Zurück zum Zitat Knaak S, Mantler E, Szeto A (2017) Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum 30:111–116CrossRefPubMedPubMedCentral Knaak S, Mantler E, Szeto A (2017) Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum 30:111–116CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Lehmann M, Hilimire MR, Yang LH et al (2016) Investigating the relationship between self-esteem and stigma among young adults with history of suicide attempts. Crisis 37:265–270CrossRefPubMed Lehmann M, Hilimire MR, Yang LH et al (2016) Investigating the relationship between self-esteem and stigma among young adults with history of suicide attempts. Crisis 37:265–270CrossRefPubMed
19.
Zurück zum Zitat Lewitzka U, Wolfersdorf M (2016) Aktuelle psychopharmakologische und psychotherapeutische Strategien der Suizidprävention. Nervenarzt 87:465–466CrossRefPubMed Lewitzka U, Wolfersdorf M (2016) Aktuelle psychopharmakologische und psychotherapeutische Strategien der Suizidprävention. Nervenarzt 87:465–466CrossRefPubMed
20.
Zurück zum Zitat Link BG, Mirotznik J, Cullen FT (1991) The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? J Health Soc Behav 32(3):302–320CrossRefPubMed Link BG, Mirotznik J, Cullen FT (1991) The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? J Health Soc Behav 32(3):302–320CrossRefPubMed
21.
Zurück zum Zitat Mulfinger N, Müller S, Böge I et al. Honest, Open, Proud for Adolescents With Mental Illness: A Randomized Controlled Trial. In Revision. Mulfinger N, Müller S, Böge I et al. Honest, Open, Proud for Adolescents With Mental Illness: A Randomized Controlled Trial. In Revision.
22.
Zurück zum Zitat Oexle N, Ajdacic-Gross V, Kilian R et al (2017) Mental illness stigma, secrecy and suicidal ideation. Epidemiol Psychiatr Sci 26:53–60CrossRefPubMed Oexle N, Ajdacic-Gross V, Kilian R et al (2017) Mental illness stigma, secrecy and suicidal ideation. Epidemiol Psychiatr Sci 26:53–60CrossRefPubMed
23.
Zurück zum Zitat Oexle N, Rüsch N, Viering S et al (2017) Self-stigma and suicidality: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 267:359–361CrossRefPubMed Oexle N, Rüsch N, Viering S et al (2017) Self-stigma and suicidality: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 267:359–361CrossRefPubMed
25.
Zurück zum Zitat Oexle N, Preiss K, Staiger T et al Stigma and its contribution to suicidality from the perspective of suicide attempt survivors: a qualitative study. In Revision. Oexle N, Preiss K, Staiger T et al Stigma and its contribution to suicidality from the perspective of suicide attempt survivors: a qualitative study. In Revision.
26.
Zurück zum Zitat Pachankis JE (2007) The psychological implications of concealing a stigma: a cognitive-affective-behavioral model. Psychol Bull 133:328CrossRefPubMed Pachankis JE (2007) The psychological implications of concealing a stigma: a cognitive-affective-behavioral model. Psychol Bull 133:328CrossRefPubMed
27.
Zurück zum Zitat Pitman AL, Osborn DP, Rantell K, King MB (2016) Bereavement by suicide as a risk factor for suicide attempt: a cross-sectional national UK-wide study of 3432 young bereaved adults. BMJ Open 6:e9948CrossRefPubMedPubMedCentral Pitman AL, Osborn DP, Rantell K, King MB (2016) Bereavement by suicide as a risk factor for suicide attempt: a cross-sectional national UK-wide study of 3432 young bereaved adults. BMJ Open 6:e9948CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Qin P, Agerbo E, Mortensen PB (2002) Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case-control study based on longitudinal registers. Lancet 360:1126–1130CrossRefPubMed Qin P, Agerbo E, Mortensen PB (2002) Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case-control study based on longitudinal registers. Lancet 360:1126–1130CrossRefPubMed
29.
Zurück zum Zitat Reynders A, Kerkhof AJ, Molenberghs G, Van Audenhove C (2015) Help-seeking, stigma and attitudes of people with and without a suicidal past. A comparison between a low and a high suicide rate country. J Affect Disord 178:5–11CrossRefPubMed Reynders A, Kerkhof AJ, Molenberghs G, Van Audenhove C (2015) Help-seeking, stigma and attitudes of people with and without a suicidal past. A comparison between a low and a high suicide rate country. J Affect Disord 178:5–11CrossRefPubMed
30.
Zurück zum Zitat Ross AM, Kelly CM, Jorm AF (2014) Re-development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study. BMC Psychiatry 14:241CrossRefPubMedPubMedCentral Ross AM, Kelly CM, Jorm AF (2014) Re-development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study. BMC Psychiatry 14:241CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Rüsch N, Angermeyer MC, Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20:529–539CrossRefPubMed Rüsch N, Angermeyer MC, Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20:529–539CrossRefPubMed
32.
Zurück zum Zitat Rüsch N, Abbruzzese E, Hagedorn E et al (2014) Efficacy of Coming Out Proud to reduce stigma’s impact among people with mental illness: pilot randomised controlled trial. Br J Psychiatry 204:391–397CrossRefPubMedPubMedCentral Rüsch N, Abbruzzese E, Hagedorn E et al (2014) Efficacy of Coming Out Proud to reduce stigma’s impact among people with mental illness: pilot randomised controlled trial. Br J Psychiatry 204:391–397CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Rüsch N, Müller M, Heekeren K et al (2014) Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis. Schizophr Res 158:82–84CrossRefPubMed Rüsch N, Müller M, Heekeren K et al (2014) Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis. Schizophr Res 158:82–84CrossRefPubMed
34.
Zurück zum Zitat Rüsch N, Zlati A, Black G, Thornicroft G (2014) Does the stigma of mental illness contribute to suicidality? Br J Psychiatry 205:257–259CrossRefPubMed Rüsch N, Zlati A, Black G, Thornicroft G (2014) Does the stigma of mental illness contribute to suicidality? Br J Psychiatry 205:257–259CrossRefPubMed
35.
Zurück zum Zitat Schibalski JV, Müller M, Ajdacic-Gross V et al (2017) Stigma-related stress, shame and avoidant coping reactions among members of the general population with elevated symptom levels. Compr Psychiatry 74:224–230CrossRefPubMed Schibalski JV, Müller M, Ajdacic-Gross V et al (2017) Stigma-related stress, shame and avoidant coping reactions among members of the general population with elevated symptom levels. Compr Psychiatry 74:224–230CrossRefPubMed
36.
Zurück zum Zitat Schomerus G, Evans-Lacko S, Rüsch N et al (2015) Collective levels of stigma and national suicide rates in 25 European countries. Epidemiol Psychiatr Sci 24:166–171CrossRefPubMed Schomerus G, Evans-Lacko S, Rüsch N et al (2015) Collective levels of stigma and national suicide rates in 25 European countries. Epidemiol Psychiatr Sci 24:166–171CrossRefPubMed
37.
Zurück zum Zitat Sheehan L, Dubke R, Corrigan PW (2017) The specificity of public stigma: a comparison of suicide and depression-related stigma. Psychiatry Res 256:40–45CrossRefPubMed Sheehan L, Dubke R, Corrigan PW (2017) The specificity of public stigma: a comparison of suicide and depression-related stigma. Psychiatry Res 256:40–45CrossRefPubMed
38.
Zurück zum Zitat Sheehan LL, Corrigan PW, Al-Khouja MA (2016) Stakeholder perspectives on the stigma of suicide attempt survivors. Crisis 38:73–81CrossRefPubMed Sheehan LL, Corrigan PW, Al-Khouja MA (2016) Stakeholder perspectives on the stigma of suicide attempt survivors. Crisis 38:73–81CrossRefPubMed
39.
Zurück zum Zitat Thornicroft G, Mehta N, Clement S et al (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 387:1123–1132CrossRefPubMed Thornicroft G, Mehta N, Clement S et al (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 387:1123–1132CrossRefPubMed
40.
Zurück zum Zitat Xu Z, Mayer B, Müller M et al (2016) Stigma and suicidal ideation among young people at risk of psychosis after one year. Psychiatry Res 243:219–224CrossRefPubMed Xu Z, Mayer B, Müller M et al (2016) Stigma and suicidal ideation among young people at risk of psychosis after one year. Psychiatry Res 243:219–224CrossRefPubMed
41.
Zurück zum Zitat Yanos PT, Lucksted A, Drapalski AL et al (2015) Interventions targeting mental health self-stigma: a review and comparison. Psychiatr Rehabil J 38:171–178CrossRefPubMed Yanos PT, Lucksted A, Drapalski AL et al (2015) Interventions targeting mental health self-stigma: a review and comparison. Psychiatr Rehabil J 38:171–178CrossRefPubMed
42.
Zurück zum Zitat Yoshimasu K, Kiyohara C, Miyashita K (2008) Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies. Environ Health Prev Med 13:243–256CrossRefPubMedPubMedCentral Yoshimasu K, Kiyohara C, Miyashita K (2008) Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies. Environ Health Prev Med 13:243–256CrossRefPubMedPubMedCentral
Metadaten
Titel
Stigma – Risikofaktor und Konsequenz suizidalen Verhaltens
Implikationen für die Suizidprävention
verfasst von
N. Oexle
N. Rüsch
Publikationsdatum
16.11.2017
Verlag
Springer Medizin
Schlagwörter
Suizid
Suizid
Erschienen in
Der Nervenarzt / Ausgabe 7/2018
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-017-0450-8

Weitere Artikel der Ausgabe 7/2018

Der Nervenarzt 7/2018 Zur Ausgabe