Fordwood Samantha R, Asarnow Joan R, Huizar Diana P, Reise Steven P
Department of Psychology, University of California at Los Angeles, Los Angeles, CA 90024-1759, USA.
J Clin Child Adolesc Psychol. 2007 Jul-Sep;36(3):392-404. doi: 10.1080/15374410701444355.
Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters showed elevated levels of psychopathology, specifically depressive symptoms, externalizing behaviors, anxiety, substance use, mania, and posttraumatic stress disorder symptoms. Externalizing behaviors and depression severity uniquely contributed to the prediction of suicide attempts in multivariate analyses. High levels of environmental stress as well as a few key stressful events were associated with suicide attempts; a recent romantic breakup or being assaulted added to suicide attempt risk, beyond the effects of psychopathology. Implications of results for primary care preventive services and suicide attempt prevention are discussed.
尽管抑郁症与自杀未遂及自杀死亡密切相关，但大多数抑郁的青少年并未尝试自杀，这表明需要识别出其他风险因素。我们对451名年龄在13至21岁之间的初级保健抑郁症患者的自杀未遂情况进行了研究。在双变量分析中，被归类为自杀未遂者的青少年表现出更高水平的精神病理学症状，特别是抑郁症状、外化行为、焦虑、物质使用、躁狂和创伤后应激障碍症状。在多变量分析中，外化行为和抑郁严重程度对自杀未遂的预测具有独特的贡献。高水平的环境压力以及一些关键的应激事件与自杀未遂有关；最近的浪漫关系破裂或遭受攻击增加了自杀未遂风险，超出了精神病理学的影响。文中讨论了研究结果对初级保健预防服务和自杀未遂预防的意义。
