Sokero Petteri, Eerola Mervi, Rytsälä Heikki, Melartin Tarja, Leskelä Ulla, Lestelä-Mielonen Paula, Isometsä Erkki
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
J Affect Disord. 2006 Oct;95(1-3):95-102. doi: 10.1016/j.jad.2006.04.028. Epub 2006 Jun 15.
Suicidal ideation is likely to represent a phase preceding suicidal acts among most suicidal patients with major depressive disorder (MDD). Factors predicting reversal of the suicidal process are unknown. Our aim was to test the hypothesis that a decline in suicidal ideation is preceded by a decline in hopelessness among patients with MDD.
Of the 269 Vantaa Depression Study patients with DSM-IV MDD, 103 patients scored > or = 6 points at baseline on the Scale for Suicidal Ideation (SSI). Seventy of these patients were followed-up weekly either until they scored zero points on the SSI, or up to 26 weeks.
The median duration for a decline of suicidal ideation to zero was 2.2 months after baseline. The level of baseline suicidal ideation, depressive symptoms, and the presence of any personality disorder predicted duration of suicidal ideation. A decline in both depression (BDI) and hopelessness (HS) independently predicted a decline in suicidal ideation.
Due to study design, we do not know if suicidal ideation relapsed after the first time the patient reached zero score in the SSI.
Among patients with major depressive disorder having suicidal ideation, the decline in suicidal ideation is independently predicted by preceding declines in the levels of both depressive symptoms as well as hopelessness. The findings are consistent with possible causal roles of declines in depression and hopelessness in reversing the suicidal process.
在大多数患有重度抑郁症（MDD）的自杀患者中，自杀观念可能代表自杀行为之前的一个阶段。预测自杀过程逆转的因素尚不清楚。我们的目的是检验这样一个假设，即MDD患者自杀观念的下降之前是绝望感的下降。
在万塔抑郁症研究的269例符合DSM-IV标准的MDD患者中，103例患者在基线时自杀观念量表（SSI）得分≥6分。其中70例患者每周进行随访，直至他们在SSI上得分为零，或长达26周。
自杀观念降至零的中位持续时间为基线后2.2个月。基线自杀观念水平、抑郁症状以及是否存在任何人格障碍可预测自杀观念的持续时间。抑郁（BDI）和绝望感（HS）的下降均独立预测自杀观念的下降。
由于研究设计，我们不知道患者在SSI上首次得零分后自杀观念是否会复发。
在有自杀观念的重度抑郁症患者中，抑郁症状水平和绝望感的先前下降可独立预测自杀观念的下降。这些发现与抑郁和绝望感的下降在逆转自杀过程中可能的因果作用一致。
