Verdoux H, Liraud F, Gonzales B, Assens F, Abalan F, van Os J
Department of Psychiatry, University Victor Segalen Bordeaux 2, France, Hôpital Charles Perrens, Bordeaux, France, University of Maastricht, The Netherlands.
Acta Psychiatr Scand. 2001 May;103(5):347-54. doi: 10.1034/j.1600-0447.2001.00202.x.
To assess the baseline characteristics associated with a greater risk of suicidal behaviour (suicide and parasuicide) over the 2 years following a first admission for psychosis, and the associations between suicidality and outcome.
First-admitted subjects with psychosis (n=65) were assessed at 6-monthly intervals over a 2-year follow-up period.
Over this period, 11.3% of the patients displayed suicidal behaviour. Baseline predictors of suicidal behaviour were a lifetime history of parasuicide before first admission (OR=5.9, 95% CI 1.5-23.4), lower Positive And Negative Symptom Scale positive subscores (OR=0.8, 95% CI 0.6-0.97) and a longer duration of first admission (OR=1.1, 95% CI 1-1.2). Subjects with suicidal behaviour presented with a longer duration of psychotic symptoms (OR=1.1, 95% CI 1.02-1.2) and a greater risk of being readmitted (OR=4.6, 95%CI 1.1-19.1). Subjects with substance misuse over the follow-up period were seven times (95%CI 1.3-39) more likely to engage in suicidal behaviour.
Subjects with a previous history of parasuicide, with a deteriorating clinical course, or with substance misuse are at increased risk of suicidal behaviour in the 2 years after the onset of a first psychotic episode.
评估首次因精神病住院后2年内与自杀行为（自杀和准自杀）风险较高相关的基线特征，以及自杀倾向与结局之间的关联。
对首次因精神病住院的受试者（n = 65）在2年的随访期内每6个月进行一次评估。
在此期间，11.3%的患者表现出自杀行为。自杀行为的基线预测因素为首次入院前有准自杀史（比值比=5.9，95%置信区间1.5 - 23.4）、阳性和阴性症状量表阳性子得分较低（比值比=0.8，95%置信区间0.6 - 0.97）以及首次住院时间较长（比值比=1.1，95%置信区间1 - 1.2）。有自杀行为的受试者出现精神病症状的时间较长（比值比=1.1，95%置信区间1.02 - 1.2）且再次入院的风险较高（比值比=4.6，95%置信区间1.1 - 19.1）。随访期间有物质滥用问题的受试者出现自杀行为的可能性高出7倍（95%置信区间1.3 - 39）。
有准自杀史、临床病程恶化或有物质滥用问题的受试者在首次精神病发作后2年内出现自杀行为的风险增加。
