Angst Jules, Angst Felix, Gerber-Werder Regina, Gamma Alex
Zurich University Psychiatric Hospital, Switzerland.
Arch Suicide Res. 2005;9(3):279-300. doi: 10.1080/13811110590929488.
There is no data on the variation in the suicide risk over lifetime and on the suicide-preventive effect of the long-term treatment of mood-disorder patients with antidepressants and neuroleptics. Our research focused on 186 unipolar (D), 60 bipolar II (Dm), 130 nuclear bipolar I (MD), and 30 preponderantly manic patients (M/Md); that were followed-up from 1963 to 2003. By 2003, 45 (11.1%) of the 406 patients had committed suicide. Suicide rates were highest among D patients (Standardized Mortality Ratio, SMR = 26.4), MD (SMR = 13.6), Dm (SMR = 10.6) and lowest among M/Md patients (SMR = 4.7). Prospectively, the suicide rate decreased over the 44 years' follow-up; Lithium, neuroleptics and antidepressants reduced suicides significantly. Long-term treatment also reduced overall mortality, and combined treatments proved more effective than mono-therapy.
目前尚无关于一生中自杀风险变化以及使用抗抑郁药和抗精神病药对心境障碍患者进行长期治疗的自杀预防效果的数据。我们的研究聚焦于186名单相（D型）、60名双相II型（Dm型）、130名核心双相I型（MD型）以及30名以躁狂为主的患者（M/Md型）；这些患者从1963年至2003年接受随访。到2003年时，406名患者中有45名（11.1%）自杀。自杀率在D型患者中最高（标准化死亡率，SMR = 26.4），MD型（SMR = 13.6），Dm型（SMR = 10.6），而在M/Md型患者中最低（SMR = 4.7）。前瞻性来看，在44年的随访期间自杀率有所下降；锂盐、抗精神病药和抗抑郁药显著降低了自杀率。长期治疗还降低了总体死亡率，并且联合治疗被证明比单一疗法更有效。
