Kelly Thomas M, Cornelius Jack R, Clark Duncan B
Pittsburgh Adolescent Alcohol Research Center, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
Drug Alcohol Depend. 2004 Jan 7;73(1):87-97. doi: 10.1016/j.drugalcdep.2003.10.004.
To determine the effects of psychiatric disorders on attempted suicide among adolescents with substance use disorders (SUD).
Age of onset for psychiatric disorders, age of first suicide attempt, and the relationship of psychiatric disorder with attempted suicide were investigated in a sample of 503 adolescents with DSM-IV defined SUD (age range: 12.2-19.0 years).
Males who attempted suicide had a significantly earlier onset of alcohol use disorders (AUD) and significantly more mood, AUD, and disruptive behavior disorder symptoms compared to non-attempting males. Females who attempted suicide had a significantly earlier onset and higher counts of mood disorders and SUD symptoms compared to non-attempting females. Hazard analysis revealed that mood disorders represent the highest psychiatric risk for attempted suicide in both the genders. Attention deficit-hyperactivity disorder (ADHD) increased the risk for attempted suicide among males. The interaction of mood disorder and AUD increased the risk for attempted suicide among females.
Clinicians should closely monitor SUD adolescents for suicide risk and be aware of gender differences for suicidal behavior based on course and severity of psychiatric disorder in this population.
确定精神障碍对患有物质使用障碍（SUD）的青少年自杀未遂的影响。
在503名符合DSM-IV定义的SUD青少年样本（年龄范围：12.2 - 19.0岁）中，调查精神障碍的发病年龄、首次自杀未遂年龄以及精神障碍与自杀未遂的关系。
与未自杀未遂的男性相比，自杀未遂的男性酒精使用障碍（AUD）发病显著更早，且情绪、AUD及破坏性行为障碍症状显著更多。与未自杀未遂的女性相比，自杀未遂的女性情绪障碍和SUD症状发病显著更早且数量更多。风险分析显示，情绪障碍在两性中均是自杀未遂的最高精神风险因素。注意缺陷多动障碍（ADHD）增加了男性自杀未遂的风险。情绪障碍与AUD的相互作用增加了女性自杀未遂的风险。
临床医生应密切监测患有SUD的青少年的自杀风险，并基于该人群精神障碍的病程和严重程度了解自杀行为的性别差异。
