蓄意自傷行為之評估與處理

The Evaluation and Management of Deliberate Self-harm Behavior

蓄意自傷對現代社會的健康衝擊日益受到關注。在青少年族群中，蓄意自傷行為尤其盛行，而隨著族群年齡增加，自殺身亡的比率也隨之上升。醫護人員經常難以區別蓄意自傷行為之背後動機，究竟是自傷或是自殺。本文回顧相關文獻，介紹蓄意自傷的定義、對大眾健康之衝擊、與自殺行為之分辨、重複之行為模式、與精神疾病之共病性、風險評估、信效度良好之篩檢工具「心情溫度計」、以及基本處置原則，盼能對於第一線的醫療人員有所助益。

Concerns have been raised about the impact of deliberate self-harm on contemporary public health. The prevalence of deliberate self-harm behavior was especially high in teenagers, while complete suicide rate increases with age. Health service providers often find it difficult to distinguish the intent of deliberate self-harm from suicide. In this review article, we discussed the definition, impact on public health, the difference between deliberate self-harm and suicide, repetitive behavior patterns, comorbid psychiatric disorders, risk assessment, and Brief Symptom Rating Scale, as well as the principle of management of deliberate self-harm. We hope this article could be helpful to medical staffs facing this clinical issue.