McDermut W, Miller I W, Solomon D, Ryan C E, Keitner G I
Mood Disorders Program, Rhode Island Hospital, Providence, RI, USA.
Compr Psychiatry. 2001 Mar-Apr;42(2):96-104. doi: 10.1053/comp.2001.21220.
This study examined the association between suicidality, family factors, and clinical and diagnostic variables in depressed adult inpatients. The subjects were 121 depressed adult inpatients living with a family member or significant other. Demographic, clinical, and diagnostic information about the patient, and subjective and observer ratings of family functioning were obtained. Trained interviewers rated families of suicidal depressed patients as more dysfunctional than families of patients with no history of attempted suicide. In a logistic regression model, earlier age of depression onset, number of psychiatric hospitalizations, and objectively rated poorer family communication were associated with a history of a prior suicide attempt. Also, modest evidence suggested that patients with a prior suicide attempt perceived their families as more dysfunctional than did their respective family members. Variations in family functioning are associated with different degrees of suicidality. However, prospective longitudinal designs would elucidate the causal relation between family dysfunction and suicidal behavior.
本研究调查了成年抑郁症住院患者的自杀倾向、家庭因素与临床及诊断变量之间的关联。研究对象为121名与家庭成员或重要他人同住的成年抑郁症住院患者。获取了患者的人口统计学、临床和诊断信息,以及家庭功能的主观和观察者评分。经过培训的访谈者将有自杀倾向的抑郁症患者的家庭评定为比无自杀未遂史患者的家庭功能更差。在逻辑回归模型中,抑郁症发病年龄较早、精神病住院次数以及客观评定的较差家庭沟通与既往自杀未遂史相关。此外,有适度证据表明,有过自杀未遂史的患者比其家庭成员更认为自己的家庭功能差。家庭功能的差异与不同程度的自杀倾向相关。然而,前瞻性纵向设计将阐明家庭功能障碍与自杀行为之间的因果关系。