Farbstein Ilana, Dycian Anat, Gothelf Doron, King Robert A, Cohen Donald J, Kron Shmuel, Apter Alan
Department of Child and Adolescent Psychiatry, Rivka Ziv Hospital, Safed, Israel.
J Am Acad Child Adolesc Psychiatry. 2002 Nov;41(11):1342-9. doi: 10.1097/00004583-200211000-00016.
(1) To compare the outcome of adolescent subjects who have made a suicide attempt with the outcome of matched controls, using their psychological and psychometric screening tests for military service at age 16.5 years. Their subsequent performance during military service between ages 18 and 21 was also evaluated. (2) To compare the prognosis of those attempters who received intensive psychiatric inpatient evaluation in a general hospital with the prognosis of those who received emergency room treatment only.
The computerized military records of 216 adolescents, who had been treated between 1987 and 1988 for attempted suicide in a general hospital emergency room, prior to their induction into the army, were evaluated. They were rated on the following tests: cognitive/educational performance and psychosocial adaptation, psychiatric and psychological health diagnoses, and performance during their military service between 1989 and 1992.
Although the female attempters had slightly more problems in the military than the controls, their overall prognosis was surprisingly good. The male suicide attempters did very poorly in their subsequent military service. There was no long-term advantage in having had a psychiatric evaluation performed in a hospital over a brief emergency room evaluation. Most differences between attempters and controls were in service performance, rather than in cognitive and psychometric tests.
There may be marked differences between the sexes in the significance of attempted suicide and in the indications for intervention. The policy of mandatory general hospitalization for suicide attempters may need reevaluation.
(1)通过对16.5岁青少年进行心理和心理测量学的兵役筛查测试,比较自杀未遂青少年与匹配对照组的结果。还评估了他们在18至21岁服兵役期间的后续表现。(2)比较在综合医院接受强化精神科住院评估的自杀未遂者与仅接受急诊室治疗的自杀未遂者的预后。
对1987年至1988年期间在综合医院急诊室接受自杀未遂治疗、入伍前的216名青少年的计算机化军事记录进行评估。对他们进行了以下测试评分:认知/教育表现和心理社会适应、精神和心理健康诊断,以及1989年至1992年服兵役期间的表现。
尽管女性自杀未遂者在军队中的问题比对照组略多,但她们的总体预后出人意料地好。男性自杀未遂者在随后的服兵役中表现很差。在医院进行精神科评估与简短的急诊室评估相比,没有长期优势。自杀未遂者与对照组之间的大多数差异在于服役表现,而非认知和心理测量测试。
自杀未遂的意义和干预指征在性别上可能存在显著差异。对自杀未遂者强制进行综合住院治疗的政策可能需要重新评估。