Kelly T M, Soloff P H, Lynch K G, Haas G L, Mann J J
Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
J Pers Disord. 2000 Winter;14(4):316-26. doi: 10.1521/pedi.2000.14.4.316.
This study investigated the impact of recent life events and social adjustment on suicide attempter status in 34 patients with major depression, 24 patients with borderline personality disorder, and 22 patients with co-morbid major depression and borderline personality disorder. Suicide attempters reported more recent life events and scored lower on a measure of social adjustment in their families and overall social adjustment, compared with non-attempters. Borderline disordered and borderline or depressed patients were more likely to have attempted suicide than patients with major depression only. Recent life events did not predict attempter status. Lower social adjustment in the immediate family and lower overall social adjustment were predictive of suicide attempter classification, regardless of diagnosis. Borderline disordered patients low on overall social adjustment were over 16 times more likely to have attempted suicide than patients diagnosed with major depression only. Recent life events may elevate suicide risk in groups already at high risk for suicide completion, whereas high levels of social adjustment may be protective against stress-related suicidal behavior.
本研究调查了近期生活事件和社会适应对34例重度抑郁症患者、24例边缘型人格障碍患者以及22例合并重度抑郁症和边缘型人格障碍患者自杀未遂状况的影响。与未自杀未遂者相比,自杀未遂者报告了更多近期生活事件,并且在家庭社会适应及总体社会适应的一项测量中得分更低。边缘型人格障碍患者以及边缘型人格障碍或抑郁症患者比仅患有重度抑郁症的患者更有可能自杀未遂。近期生活事件并不能预测自杀未遂状况。直系家庭中较低的社会适应及较低的总体社会适应可预测自杀未遂分类,无论诊断结果如何。总体社会适应水平较低的边缘型人格障碍患者自杀未遂的可能性比仅诊断为重度抑郁症的患者高出16倍以上。近期生活事件可能会提高已处于高自杀完成风险群体的自杀风险,而高水平的社会适应可能会预防与压力相关的自杀行为。