Renaud J, Brent D A, Birmaher B, Chiappetta L, Bridge J
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA.
J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):846-51. doi: 10.1097/00004583-199907000-00014.
To determine the psychiatric risk factors for suicide in adolescents with disruptive disorders.
Fifty-nine adolescent suicide completers and 18 community controls, both having a probable or definite current DSM-III diagnosis of disruptive disorders, were compared.
Adolescents with disruptive disorders who committed suicide had higher rates of current substance abuse, past suicide attempt, family history of substance abuse, and family history of mood disorder than disruptive community controls.
Disruptive adolescents appear to be at risk for completed suicide when comorbid substance abuse and past history of suicide attempt are present. The risk increases if the adolescents have a past history of physical abuse and if they have parents with substance abuse and mood disorders. Clinicians should be aware of these risk factors and implement active interventions to prevent suicide. Treatment should focus on treating not only the adolescents, but also their family members. The findings of this study also highlight the need for future research in the prevention of suicide in adolescents with disruptive disorders and comorbid substance abuse.
确定患有破坏性行为障碍的青少年自杀的精神危险因素。
对59例青少年自杀成功者和18例社区对照者进行比较，二者均有当前可能或确定的DSM-III破坏性行为障碍诊断。
与社区对照的破坏性行为障碍患者相比，自杀的破坏性行为障碍青少年当前药物滥用、既往自杀未遂、药物滥用家族史和心境障碍家族史的发生率更高。
当存在共病药物滥用和既往自杀未遂史时，有破坏性行为障碍的青少年似乎有自杀死亡风险。如果青少年有身体虐待史，且其父母有药物滥用和心境障碍，风险会增加。临床医生应意识到这些危险因素并实施积极干预以预防自杀。治疗不仅应关注青少年，还应关注其家庭成员。本研究结果还凸显了未来对患有破坏性行为障碍和共病药物滥用的青少年预防自杀进行研究的必要性。
