Differential diagnostic of self-destructive behaviour via structural-dynamic model

Abstract

Objectives

Structural-dynamic model (SDM) of self-destructive behaviour (SdB) is needed for differential diagnostic of numerous features of SdB. SDM is based on an awareness that self-destructiveness has different variants with diversity of psychophysical damage as its outcome. SDM describes whole continuum of SdB variations and helps to differentiate them, to assess risk of suicidal or non-suicidal activity and to do long-term prognosis for SdB development as well.

Methods

SDM of SdB is a generalized conception, which is a result of consequent scientific researches. The clinical criteria by ICD-10 and semi-structured suicidological interview were used in all of the surveys. In general, we observed 860 patients with suicidal attempt, suicidal ideas and self-destructive injuries.

Results

Our researches proved that SDM of SdB determine suicidological diagnosis implementing all-round assessment of SdB features of patient using kinds, forms and clinical-pathogenetic types as main categories of this concept. The kinds of SdB are: self-aggressive behaviour, self-destructive behaviour (it includes non-suicidal or psychotic variants) and suicidal behaviour. Each kind of SdB helps to detect pathogenetic mechanisms and dynamic tendencies in development of it. The form of SdB discloses behavioural specification in each case. There are equivalent, internal and external forms. The clinical-pathogenetic types of SdB are: suicidal, parasuicidal, pseudosuicidal or asuicidal. Each of them discloses significant clinical characteristics of actual self-destructive episode (nosology, syndrome, psychological traits, situation peculiarities, etc.). The differential diagnostic of SdB by SDM concept will allow doctors to treat patients more accurately and effectively.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.