Liu I-Chao, Chiu Chen-huan
Department of Psychiatry, Cardinal Tien Hospital and Fu Jen Medical School, Xindian City, Taiwan.
Int Psychogeriatr. 2009 Oct;21(5):896-902. doi: 10.1017/S1041610209990056. Epub 2009 Jun 19.
Prior studies have inadequately explored the relationship between late-life suicidal behavior and subclinical/clinical symptoms. This study aimed to assess the risk associated with subclinical symptoms, mild cognitive impairment and clinical factors among late-life suicide attempters.
Forty-three elderly patients aged 60 years and older who sought emergency services in a university-affiliated general hospital for attempting suicide and 43 comparison subjects participated in this study between March 2005 and December 2006. The comparison group was recruited by advertising in the community around the hospital. DSM-IV based diagnostic interview and screening instruments including the GDS, MMSE, BSRS-5 and APGAR were applied. Adjusted odds ratios were measured in the final multiple logistic regression model.
Suicide attempters were more likely to meet a diagnosis of depressive disorder, after adjustments for BSRS-5 score and drinking habit. The adjusted odds of suicide among people with a BSRS-5 score of more than 5 points was 17.8 times higher than those with the BSRS score less than or equal to 5 points.
Our findings support the significant impact on late-life suicidal behavior from the assessment of subclinical symptoms, including anxiety, depression, hostility, sleep condition and interpersonal symptoms. The assessment of subclinical symptoms by the BSRS-5 may help in the future prevention of late-life suicidal behavior in primary care settings.
先前的研究对晚年自杀行为与亚临床/临床症状之间的关系探讨不足。本研究旨在评估晚年自杀未遂者中亚临床症状、轻度认知障碍和临床因素相关的风险。
2005年3月至2006年12月期间,43名60岁及以上因自杀未遂在一所大学附属医院寻求急诊服务的老年患者和43名对照受试者参与了本研究。对照组通过在医院周边社区张贴广告招募。应用基于《精神疾病诊断与统计手册》第四版(DSM-IV)的诊断访谈和筛查工具,包括老年抑郁量表(GDS)、简易精神状态检查表(MMSE)、简明症状自评量表-5(BSRS-5)和阿普加量表(APGAR)。在最终的多因素逻辑回归模型中测量调整后的比值比。
在对BSRS-5评分和饮酒习惯进行调整后,自杀未遂者更有可能符合抑郁症的诊断。BSRS-5评分超过5分的人群自杀调整后的几率比BSRS评分小于或等于5分的人群高17.8倍。
我们的研究结果支持亚临床症状评估(包括焦虑、抑郁、敌意、睡眠状况和人际症状)对晚年自杀行为有重大影响。通过BSRS-5评估亚临床症状可能有助于未来在初级保健环境中预防晚年自杀行为。