Guthrie Elspeth, Kapur Navneet, Mackway-Jones Kevin, Chew-Graham Carolyn, Moorey James, Mendel Elizabeth, Francis Fredrika Marino, Sanderson Sarah, Turpin Clive, Boddy Gary
School of Psychiatry and Behavioural Sciences, University of Manchester, Manchester Royal Infirmary, UK.
Aust N Z J Psychiatry. 2003 Oct;37(5):532-6. doi: 10.1046/j.1440-1614.2003.01197.x.
We found that brief psychodynamic-interpersonal therapy was more helpful than usual care in deliberate self-poisoning patients, and resulted in reduced suicidal ideation and repetition of self-harm in the 6 months post-treatment. Here, we explore which baseline factors predicted outcome following treatment.
Patients presenting to an emergency department with deliberate self-poisoning were randomly assigned to brief psychodynamic-interpersonal therapy (PIT) or usual care. Severity of suicidal ideation 6 months post-treatment was used as the main outcome measure. Sociodemographic features and baseline psychological measures were used as predictor variables. Univariate and regression analyses were used to identify predictors of outcome for the whole group and for those who received psychotherapy.
Principal predictors for the psychotherapy group were baseline severity of depression and a prior history of self-harm. For the group as a whole predictors were severity of suicidal ideation, anxiety and prior history of self-harm.
Four session PIT for deliberate self-poisoning is effective in reducing suicidal ideation in patients with less severe depression, no prior history of self-harm, and who have not consumed alcohol with the overdose. Extended therapy may be indicated for those with more severe depression.
我们发现,对于蓄意自我中毒患者,简短的心理动力人际治疗比常规护理更有帮助,且在治疗后的6个月内可减少自杀意念和自我伤害的重复发生。在此,我们探讨哪些基线因素可预测治疗后的结果。
因蓄意自我中毒就诊于急诊科的患者被随机分配至简短的心理动力人际治疗(PIT)组或常规护理组。将治疗后6个月时自杀意念的严重程度作为主要结局指标。社会人口学特征和基线心理测量指标用作预测变量。采用单因素分析和回归分析来确定整个组以及接受心理治疗患者的结局预测因素。
心理治疗组的主要预测因素为基线抑郁严重程度和既往自我伤害史。对于整个组而言,预测因素为自杀意念严重程度、焦虑和既往自我伤害史。
针对蓄意自我中毒的四节心理动力人际治疗对于抑郁程度较轻、无既往自我伤害史且过量服药时未饮酒的患者,在减少自杀意念方面有效。对于抑郁程度更严重的患者,可能需要延长治疗。