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进入物质使用障碍治疗一年后自杀未遂的预测因素。

Predictors of a suicide attempt one year after entry into substance use disorder treatment.

作者信息

Ilgen Mark A, Harris Alex H S, Moos Rudolf H, Tiet Quyen Q

机构信息

Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025, USA.

出版信息

Alcohol Clin Exp Res. 2007 Apr;31(4):635-42. doi: 10.1111/j.1530-0277.2007.00348.x.

Abstract

BACKGROUND

The present study examined the patient intake and treatment-related risk factors associated with a suicide attempt in the 30 days before a 1-year posttreatment assessment.

METHODS

A national sample of 8,807 patients presenting for treatment of substance use disorders (SUDs) in the Department of Veterans Affairs healthcare system were assessed at treatment intake and follow-up. Using the MacArthur Model, the risk and protective factors for suicide attempt were identified at baseline and during treatment.

RESULTS

At follow-up, 4% (314/8,807) of the patients reported a suicide attempt within the past 30 days. Baseline predictors of a suicide attempt before follow-up included elevated suicidal/psychiatric symptoms, more recent problematic alcohol use, and longer duration of cocaine use. Contact with the criminal justice system was a protective factor that reduced the likelihood of a future suicide attempt. Greater engagement in SUD treatment was also associated with a reduction in suicide risk.

CONCLUSIONS

More involvement in SUD treatment reduced the likelihood of a future suicide attempt in high-risk patients. Substance use disorder treatment providers interested in reducing future suicidal behavior may want to concentrate their efforts on identifying at-risk individuals and actively engaging these patients in longer treatment episodes.

摘要

背景

本研究调查了在治疗后1年评估前30天内与自杀未遂相关的患者收治情况及治疗相关风险因素。

方法

对退伍军人事务部医疗系统中8807名前来治疗物质使用障碍(SUDs)的患者进行全国抽样,在治疗收治时和随访时进行评估。采用麦克阿瑟模型,在基线和治疗期间确定自杀未遂的风险和保护因素。

结果

随访时,4%(314/8807)的患者报告在过去30天内有过自杀未遂。随访前自杀未遂的基线预测因素包括自杀/精神症状升高、近期酒精使用问题较多以及可卡因使用时间较长。与刑事司法系统接触是一个保护因素,可降低未来自杀未遂的可能性。更多地参与SUD治疗也与自杀风险降低相关。

结论

更多地参与SUD治疗可降低高危患者未来自杀未遂的可能性。对减少未来自杀行为感兴趣的物质使用障碍治疗提供者可能希望集中精力识别高危个体,并积极让这些患者参与更长疗程的治疗。

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