De Hert M, McKenzie K, Peuskens J
University Centre St. Jozef, Leuvensesteenweg 517, B-3070 Kortenberg, Belgium.
Schizophr Res. 2001 Mar 1;47(2-3):127-34. doi: 10.1016/s0920-9964(00)00003-7.
Ten per cent of patients with schizophrenia commit suicide, but assessment of risk is difficult. Large case-control studies with a long follow-up period are needed. These should focus on patients from one age group to give clinicians the details required to identify those at highest risk.We present a case-control study of 63 patients who committed suicide and 63 controls from a consecutive admission series of patients with a diagnosis of schizophrenia. All patients were under the age of 30 at admission.Risk factors for suicide were male gender, chronic illness with frequent relapses (OR 6.0), frequent short hospitalisation, a negative attitude towards treatment (OR non-compliance 7.0), impulsive behaviour (OR acting out 6.4, OR involuntary commitment 17), parasuicide (OR suicide attempt 4.8, OR highly lethal suicide attempt 11), high pre-morbid IQ (OR 4.3), psychosis (OR 7.0) and depression (OR 36). However, early onset of a defect state (OR 6.3) and a daily activity (OR 4.2) were protective factors. Identified risk factors could help clinicians to target high-risk patients and form the basis for interventions aimed at reducing suicide.
10%的精神分裂症患者会自杀，但风险评估却很困难。需要开展长期随访的大型病例对照研究。这些研究应聚焦于某一年龄段的患者，以便为临床医生提供识别高危患者所需的详细信息。我们进行了一项病例对照研究，研究对象为63例自杀患者以及63例来自连续收治的精神分裂症诊断患者系列的对照。所有患者入院时年龄均在30岁以下。自杀的风险因素包括男性、频繁复发的慢性病（比值比6.0）、频繁短期住院、对治疗的消极态度（不依从比值比7.0）、冲动行为（付诸行动比值比6.4，非自愿住院比值比17）、准自杀行为（自杀未遂比值比4.8，高度致命自杀未遂比值比11）、病前智商高（比值比4.3）、精神病（比值比7.0）和抑郁（比值比36）。然而，缺陷状态的早发（比值比6.3）和日常活动（比值比4.2）是保护因素。识别出的风险因素有助于临床医生锁定高危患者，并为旨在降低自杀率的干预措施奠定基础。
