Scocco P, Marietta P, Tonietto M, Dello Buono M, De Leo D
Suicidological Unit, University of Padua, Italy.
Psychopathology. 2000 May-Jun;33(3):143-50. doi: 10.1159/000029136.
In this study, we describe psychological symptoms, any relationship with suicidal intention in a sample of subjects recently attempting suicide and the predictive value of this association in later completed suicide.
An assessment was made of 467 suicidological consultations carried out by the Suicidology Unit of the Department of Neurology and Psychiatry, University of Padua, on 421 patients admitted to hospital following attempted suicide in the 5-year period 1990-1994. Suicidal intention was appraised by the Intent Score Scale (ISS). Suicide mortality was assessed after a mean follow-up period of 3.5 years.
Psychiatric evaluation was completely negative in only 8% of cases. The most commonly identified symptom was depressed mood (79% of cases, 22% severe depression), followed by anxiety (43% of cases, 32% severe anxiety). From the study, it emerged that psychopathology seemed to influence suicidal intent, where this was characterized by severe depression. Anxiety and other symptoms appeared to have a secondary role. Assessments of suicidal intent showed that intention heightened as the number of symptoms increased. The symptom 'anxiety' did not prove to have a significant bearing on assessment of the seriousness of suicidal intention, whereas severely depressed mood did. The total number of subsequent suicide victims was 5.5%. During consultation relating to the index parasuicide, these subjects did not manifest a discriminate psychopathological profile (the only distinguishing characteristic was anxiety, which was less frequently identified in suicide victims), but did present a more positive personal and family psychiatric history.
In subjects who had recently attempted suicide, the psychopathological profile appeared to be related to suicidal intent, where this was characterized by severe depression. Anxiety and other symptoms seemed to have a secondary role. Nonetheless, both total scores and subscores should be taken into consideration when assessing suicidal intention through the ISS. The psychopathological profile and ISS score following attempted suicide do not appear to permit prediction, in the medium to long term, of subsequent completed suicide.
在本研究中，我们描述了近期有自杀未遂行为的受试者样本中的心理症状、其与自杀意图的任何关系，以及这种关联对后来自杀身亡的预测价值。
对1990年至1994年期间帕多瓦大学神经学和精神病学系自杀学小组进行的467次自杀学咨询进行了评估，这些咨询针对的是421名因自杀未遂而住院的患者。自杀意图通过意图评分量表（ISS）进行评估。在平均3.5年的随访期后评估自杀死亡率。
仅8%的病例精神科评估完全为阴性。最常发现的症状是情绪低落（79%的病例，22%为重度抑郁），其次是焦虑（43%的病例，32%为重度焦虑）。从研究中可以看出，精神病理学似乎会影响自杀意图，其特征为重度抑郁。焦虑和其他症状似乎起次要作用。自杀意图评估显示，随着症状数量的增加，意图增强。“焦虑”症状并未被证明对自杀意图严重性的评估有显著影响，而重度情绪低落则有影响。随后自杀身亡的受害者总数为5.5%。在与首次自杀未遂相关的咨询中，这些受试者没有表现出独特的精神病理学特征（唯一的区别特征是焦虑，在自杀受害者中较少发现），但确实有更积极的个人和家族精神病史。
在近期有自杀未遂行为的受试者中，精神病理学特征似乎与自杀意图相关，其特征为重度抑郁。焦虑和其他症状似乎起次要作用。尽管如此，通过ISS评估自杀意图时，总分和子分都应予以考虑。自杀未遂后的精神病理学特征和ISS评分似乎无法在中长期预测随后的自杀身亡情况。
