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儿童和青少年自杀中的当前精神疾病发病率、攻击性/冲动性及人格维度:一项病例对照研究

Current psychiatric morbidity, aggression/impulsivity, and personality dimensions in child and adolescent suicide: a case-control study.

作者信息

Renaud Johanne, Berlim Marcelo T, McGirr Alexander, Tousignant Michel, Turecki Gustavo

机构信息

Depressive Disorders Program, and the McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada H4H 1R3.

出版信息

J Affect Disord. 2008 Jan;105(1-3):221-8. doi: 10.1016/j.jad.2007.05.013. Epub 2007 Jun 12.

DOI:10.1016/j.jad.2007.05.013
PMID:17568682
Abstract

OBJECTIVE

The present study was designed to evaluate psychiatric risk factors for child and adolescent suicide, and to determine the association between impulsive-aggressive and other personality traits, and suicide completion in this population.

METHOD

Psychiatric diagnoses, impulsive-aggressive and other personality traits were assessed in 55 child and adolescent suicide victims and 55 community controls using semi-structured proxy-based interviews and questionnaires.

RESULTS

The most significant psychiatric risk factors associated with child and adolescent suicide were depressive disorders (OR=48.414, 95% CI 6.247-375.185), substance/alcohol abuse disorder (OR=5.365, 95% CI 1.434-20.076), and disruptive disorders (OR=13.643, 95% CI 2.292-23.16). Additionally, suicide victims showed higher scores on lifetime aggression/impulsivity, and harm avoidance. However, after logistic regression, the only independent significant predictors of suicide in this age group were the presence of depressive disorders (Adjusted OR (AOR)=39.652, 95% CI 4.501-349.345), substance/alcohol abuse disorders (AOR=7.325, 95% CI 1.127-47.62), and disruptive disorders (AOR=6.464, 95% CI 1.422-29.38).

LIMITATIONS

Relatively small sample size, and cross-sectional design.

CONCLUSIONS

Our findings confirm the existence of a particular clinical profile of children and adolescents at high risk for suicide. Additionally, our results reinforce the need for improved understanding of the interrelationships between stressors, depression, substance/alcohol abuse disorders, disruptive disorders and personality traits/dimensions in youth suicidal behavior.

摘要

目的

本研究旨在评估儿童和青少年自杀的精神风险因素,并确定冲动攻击型及其他人格特质与该人群自杀既遂之间的关联。

方法

采用基于半结构化代理人的访谈和问卷,对55名儿童和青少年自杀受害者及55名社区对照者进行精神疾病诊断、冲动攻击型及其他人格特质评估。

结果

与儿童和青少年自杀相关的最显著精神风险因素为抑郁障碍(比值比[OR]=48.414,95%置信区间[CI] 6.247 - 375.185)、物质/酒精滥用障碍(OR=5.365,95% CI 1.434 - 20.076)以及行为紊乱障碍(OR=13.643,95% CI 2.292 - 23.16)。此外,自杀受害者在终生攻击/冲动性及回避伤害方面得分更高。然而,经逻辑回归分析,该年龄组自杀的唯一独立显著预测因素为抑郁障碍的存在(调整后OR[AOR]=39.652,95% CI 4.501 - 349.345)、物质/酒精滥用障碍(AOR=7.325,95% CI 1.127 - 47.62)以及行为紊乱障碍(AOR=6.464,95% CI 1.422 - 29.38)。

局限性

样本量相对较小且为横断面设计。

结论

我们的研究结果证实了存在具有自杀高风险的儿童和青少年特定临床特征。此外,我们的结果强化了进一步理解应激源、抑郁、物质/酒精滥用障碍、行为紊乱障碍以及青年自杀行为中的人格特质/维度之间相互关系的必要性。

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