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抑郁症患者出院后治疗期间自杀观念的出现。

The emergence of suicidal ideation during the post-hospital treatment of depressed patients.

作者信息

Gaudiano Brandon A, Andover Margaret S, Miller Ivan W

机构信息

Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Butler Hospital, Providence, RI, USA.

出版信息

Suicide Life Threat Behav. 2008 Oct;38(5):539-51. doi: 10.1521/suli.2008.38.5.539.

Abstract

There is a paucity of research on the emergence of suicidal ideation in recently hospitalized patients undergoing treatment for depression. As part of a larger clinical trial, patients (N = 103) with major depression without suicidal ideation at hospital discharge were followed for up to 6 months while receiving study-related outpatient treatments. Fifty-five percent reported the emergence of suicidal ideation during the outpatient period, with the vast majority (79%) exhibiting this problem within the first 2 months post-discharge. Seventy percent of those reporting severe suicidality prior to hospitalization exhibited a reemergence of suicidal ideation post-discharge. However, 29% without significant suicidality at the index hospitalization later developed suicidal ideation during the outpatient treatment period. A faster time to the emergence of suicidal ideation was predicted by both higher prehospitalization levels of suicidal ideation as well as greater depression severity at hospital discharge. Overall, rates of emergent suicidal ideation found in the current sample of recently hospitalized patients were higher than those reported in previous outpatient samples.

摘要

对于近期住院接受抑郁症治疗的患者中自杀意念的出现,相关研究较少。作为一项更大规模临床试验的一部分,对出院时无自杀意念的重度抑郁症患者(N = 103)进行了长达6个月的随访,期间他们接受与研究相关的门诊治疗。55%的患者报告在门诊治疗期间出现了自杀意念,其中绝大多数(79%)在出院后的前2个月内出现了这一问题。70%在住院前有严重自杀倾向的患者在出院后再次出现了自杀意念。然而,29%在首次住院时无明显自杀倾向的患者在门诊治疗期间后来出现了自杀意念。自杀意念出现的时间越早,预测因素包括住院前自杀意念水平较高以及出院时抑郁程度较重。总体而言,当前近期住院患者样本中出现自杀意念的比率高于先前门诊样本中报告的比率。

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本文引用的文献

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Recurrence of suicidal ideation across depressive episodes.抑郁发作期间自杀意念的复发。
J Affect Disord. 2006 Apr;91(2-3):189-94. doi: 10.1016/j.jad.2006.01.002. Epub 2006 Feb 20.
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Treatment matching in the posthospital care of depressed patients.抑郁症患者出院后护理中的治疗匹配
Am J Psychiatry. 2005 Nov;162(11):2131-8. doi: 10.1176/appi.ajp.162.11.2131.

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