Holmstrand Cecilia, Niméus Anders, Träskman-Bendz Lil
Department of Psychiatry, University Hospital, Lund, Sweden.
Nord J Psychiatry. 2006;60(2):162-7. doi: 10.1080/08039480600583597.
The objective of this study was to find risk factors for suicide by looking for clinical and care/treatment consumption differences between 15 hospitalized suicide attempters, who later committed suicide ("completers"), and 15 suicide attempters who did not ("non-completers"), matched according to sex, age and principal diagnosis. Completers had significantly more often attempted suicide after the index admission. After index, completers had received more psychiatric care and treatment than non-completers. Comorbidity was common in both groups of patients. Personality disorders according to the DSM III-R, axis II, Cluster B, however, tended to be more common in the completer group. Increased comorbidity over time could also be seen to a larger extent in completers. In spite of the matching of principal diagnosis, completers tended to have higher Montgomery-Asberg Depression Rating Scale ratings than non-completers. They also had significantly higher Suicide Assessment Scale (SUAS) scores. From this study, it is apparent that suicide attempters at risk of future suicide have major and multiple psychiatric problems, which cause difficulties in the care and treatment.
本研究的目的是通过寻找15例住院自杀未遂者(后来自杀,即“完成者”)与15例未自杀的自杀未遂者(“未完成者”)之间的临床及护理/治疗消耗差异,来找出自杀的风险因素,两组在性别、年龄和主要诊断方面进行了匹配。完成者在首次入院后自杀未遂的情况更为常见。首次入院后,完成者接受的精神科护理和治疗比未完成者更多。两组患者中合并症都很常见。然而,根据《精神疾病诊断与统计手册》第三版修订本(DSM III-R)轴II B类人格障碍在完成者组中往往更为常见。随着时间的推移,完成者中合并症增加的情况也更为明显。尽管主要诊断进行了匹配,但完成者的蒙哥马利-阿斯伯格抑郁评定量表评分往往高于未完成者。他们的自杀评估量表(SUAS)得分也显著更高。从这项研究可以明显看出,有未来自杀风险的自杀未遂者存在严重且多重的精神问题,这给护理和治疗带来了困难。