PDF(Pubmed)
Abstract：
This case presents the situation of a 66-year-old woman diagnosed with Multiple System Atrophy Parkinsonian Type who underwent deep brain stimulation (DBS) therapy and subsequently made two suicide attempts. Despite receiving treatment and extensive psychotherapy, her condition did not improve, leading to suicidal behavior over the course of a year. Notably, she held unrealistic beliefs about the effectiveness of DBS therapy, expressing dissatisfaction with its outcomes. Family dynamics were complex, with the patient concealing her psychological distress while coping with her worsening health condition. This severe distress culminated in two suicide attempts within a relatively short timeframe. Our psychiatric team promptly intervened, implementing a suicidality protocol and adjusting her medication regimen. Despite a documented prevalence of suicidal ideation and attempts post-DBS in the literature, the exact causes remain uncertain, with the suggested involvement of neuroimmune or neurological pathways. This case contributes to scientific understanding by shedding light on suicide attempts following ineffective DBS interventions, emphasizing the patient\'s right to be informed about potential suicide risks and the possibility of assisted suicide through a neuroethical analysis. Therefore, our case underlines the importance of psychiatric evaluation and intervention in DBS patients to prevent further suicidality, focusing on a multidisciplinary approach tailored to the patient\'s autonomy and neuroethical principles.
摘要：
该病例介绍了一名被诊断为多系统萎缩帕金森病患者的66岁妇女的情况，该妇女接受了深部脑刺激（DBS）治疗，随后进行了两次自杀尝试。尽管接受了治疗和广泛的心理治疗，她的病情没有好转,导致一年内的自杀行为。值得注意的是,她对DBS治疗的有效性抱有不切实际的信念，对其结果表示不满。家庭动态很复杂，患者在应对日益恶化的健康状况的同时隐瞒自己的心理困扰。这种严重的痛苦最终导致在相对较短的时间内两次自杀企图。我们的精神科小组迅速介入,实施自杀方案并调整她的用药方案。尽管文献中记录了自杀意念的普遍性和DBS后的尝试，确切的原因仍然不确定，与神经免疫或神经通路有关。这个案例有助于科学的理解，因为它揭示了无效的DBS干预后的自杀企图。通过神经伦理分析，强调患者有权了解潜在的自杀风险和辅助自杀的可能性。因此,我们的案例强调了对DBS患者进行精神病学评估和干预以防止进一步自杀的重要性，专注于针对患者自主性和神经伦理原则的多学科方法。
