Suicide risk psychognosis as a criterion for involuntary hospitalization of mental health patients in the prevention system of their socially dangerous behavior

Introduction: The risk evaluation of threatened suicide has been to date elaborated only in clinical, behavioral aspect. The results of specific psychodiagnostic researches is not particularly presented in domestic scientific literature. Aim: to fill in the gap as a substantial part of suicide prevention in mental health patients. Materials and methods: 76 patients with different kinds of borderline (mostly neurotic) mental disorders were studied. 51 of them were included in the main suicidal group. For comparative analysis the group was divided into two subgroups: 1. Post-suicide group: patients with uncompleted suicide attempts (12 female patients, 12 male patients). 2. Pre-suicide group: crisis hospital in-patients with obtrusive suicidal thoughts, formed suicide intentions and plans (21 female patients, 6 male patients). The control comparison group was formed with 25 same clinical department in-patients with no sign of suicide threat. Their premorbid data was not different from the main suicidal group patients data. There was no significant difference in groups mean age: 35,6, 40,5 and 38,7 correspondently. The focus in data processing was made on monitoring development of pathopsychological disorders and mechanisms that underlie the increased risk of socially dangerous behavior, which allowed to evaluate and predict the quality result of involuntary treatment, become the criteria of its modification and termination. The following methods were applied in the research: 1. Clinical analysis of the structure and dynamics of suicidal patients; 2. Motivational interview that detected main stimuli and verbalized meanings of suicidal behavior, levels of awareness of motive components, the attitude to suicidal tendency; 3. Depression (Beck А.Т., Ward C.H., Mendelson M. et al., 1961) and anxiety (Beck A.T., Steer R.A., 1993) questionnaires; 4. Sensitized tests on suicide risk evaluation: hopelessness scale (Beck A.T. et al. 1974, 1975), suicidal ideation scale (Beck A.T. et al., 1991), suicide risk scale (Patterson W.M. et al., 1983). Results and conclusion: The data obtained proves that high rank depression and depression-related experiences are the most significant clinical psychological states that determine suicide risk. The anxiety component of neurotic depressive disorders proved to be clinically neutral sign that did not notably burden suicide threat of mixed state. It is indicated that the use of recognized suicide risk scales (Beck A.T. 1961-1991/1993 and Patterson W.M. 1983) has a number of constructive limitations. The risk of subjective evaluation indexes as hopelessness state cannot fully differentiate high levels of suicide risk. The means of A. Beck scale (1991) lie in diagnostic uncertainty zone. W.M. Patterson scale is much more distinct in differentiating suicidal risk groups and what is more in high and very high risk zone it veraciously (p