Neuner Tanja, Schmid Rita, Wolfersdorf Manfred, Spiessl Hermann
Department of Psychiatry and Psychotherapy, University of Regensburg, D-93042 Regensburg, Germany.
Gen Hosp Psychiatry. 2008 Jul-Aug;30(4):324-30. doi: 10.1016/j.genhosppsych.2008.03.003.
The study aimed at exploring prevalence and risk factors of inpatient suicides and attempted suicides in a psychiatric hospital.
Based on the German psychiatric basic documentation system, 20,543 patients with 40,451 episodes of inpatient care (1995-2004) in a psychiatric state hospital were included. Besides univariate analyses, multivariate logistic regression analyses and classification and regression tree analyses were performed.
Forty-one inpatient suicides were recorded. Risk of inpatient suicide is increased for patients with resistance to psychopharmacological treatment, previous suicide attempt, severe side effects and supportive psychotherapy before admission. Two hundred fourteen inpatient suicide attempts occurred during the 10-year period. Risk factors of inpatient suicide attempt are assault, personality disorder, previous suicide attempt, psychopharmacological treatment resistance, suicidal thoughts at admission, schizophrenia, depression, female sex and length of stay.
The identified risk factors underline the need for a cautious investigation of previous suicide attempts as well as for giving special attention to patients who have problems with psychopharmacotherapy during hospitalization.
本研究旨在探讨一家精神病医院住院患者自杀及自杀未遂的发生率和危险因素。
基于德国精神病基础文档系统，纳入了一家精神病专科医院1995年至2004年期间20543例患者的40451次住院治疗情况。除单因素分析外，还进行了多因素逻辑回归分析和分类与回归树分析。
记录到41例住院患者自杀事件。对精神药物治疗有抵抗性、既往有自杀未遂史、有严重副作用以及入院前接受支持性心理治疗的患者，住院自杀风险增加。在这10年期间发生了214次住院患者自杀未遂事件。住院患者自杀未遂的危险因素包括攻击行为、人格障碍、既往自杀未遂史、对精神药物治疗有抵抗性、入院时存在自杀念头、精神分裂症、抑郁症、女性以及住院时间。
所确定的危险因素强调了对既往自杀未遂史进行谨慎调查的必要性，以及在住院期间对精神药物治疗有问题的患者给予特别关注的必要性。
