Baca-García Enrique, Oquendo Maria A, Saiz-Ruiz Jeronimo, Mann J John, de Leon Jose
Department of Psychiatry, Fundación Jiménez Diaz, Madrid, Spain.
J Clin Psychiatry. 2006 Mar;67(3):375-80. doi: 10.4088/jcp.v67n0306.
Published results from a U.S. study of depressed suicide attempters and a Madrid, Spain, study including all consecutively admitted suicide attempters suggested that aggression scores were higher in U.S. attempters. This observation led us to compare depressed attempters and controls from both suicide research centers and explore whether New York City (NYC) patients carry out suicidal acts of greater lethality than patients in Madrid. The study goals were (1) to compare aggression scores in attempters and healthy volunteers between the 2 cities and (2) to determine whether higher aggression scores are associated with greater medical lethality of suicide attempts.
The respective samples from NYC and Madrid included attempters with a DSM-IV diagnosis of major depressive disorder (N = 117 and N = 133) and healthy controls (N = 90 and N = 317). Aggression scores, measured by the Brown-Goodwin Scale, in attempters and healthy volunteers from both sites were compared using an analysis of variance model. The relationship between lethality of suicidal acts and aggression scores in attempters was assessed using logistic regression analyses. NYC subjects were recruited from 1998 to 2001, and Madrid subjects were selected from consecutive admissions in 1999.
Depressed suicide attempters from NYC made attempts of greater lethality and reported more lifetime aggressive behavior than depressed attempters in Madrid. NYC healthy volunteers also reported more aggression than their Madrid counterparts.
This pilot study suggests that the greater lethality of suicidal behavior in NYC compared to Madrid is related to higher aggression levels, although the data have limitations. Cross-cultural studies are needed to verify whether aggression and higher lethality suicide attempts share a common diathesis explaining the higher suicide rates in NYC.
美国一项针对抑郁自杀未遂者的研究以及西班牙马德里一项纳入所有连续入院自杀未遂者的研究发表的结果表明，美国自杀未遂者的攻击得分更高。这一观察结果促使我们比较两个自杀研究中心的抑郁自杀未遂者及对照，并探究纽约市（NYC）患者实施的自杀行为是否比马德里患者的自杀行为具有更高的致死性。研究目标为：（1）比较两个城市自杀未遂者与健康志愿者的攻击得分；（2）确定更高的攻击得分是否与自杀未遂的更高医疗致死性相关。
来自纽约市和马德里的各自样本包括诊断为DSM-IV重度抑郁症的自杀未遂者（分别为N = 117和N = 133）以及健康对照（分别为N = 90和N = 317）。使用方差分析模型比较两个地点的自杀未遂者及健康志愿者通过布朗-古德温量表测得的攻击得分。使用逻辑回归分析评估自杀行为致死性与自杀未遂者攻击得分之间的关系。纽约市的受试者于1998年至2001年招募，马德里的受试者选自1999年连续入院者。
与马德里的抑郁自杀未遂者相比，纽约市的抑郁自杀未遂者实施的自杀行为致死性更高，且报告的终生攻击行为更多。纽约市的健康志愿者报告的攻击性也高于马德里的健康志愿者。
这项初步研究表明，与马德里相比，纽约市自杀行为更高的致死性与更高的攻击水平有关，尽管数据存在局限性。需要进行跨文化研究来验证攻击行为与更高致死性的自杀未遂是否具有共同素质，以此解释纽约市更高的自杀率。
