Gimelfarb Yuri, Natan Zipi
Abarbanel Mental Health Center, Bat Yam, Israel.
Harefuah. 2009 Jun;148(6):355-8, 413.
Patients suffering from both psychiatric disorders and substance abuse/addiction are titled "dual diagnosis patients" (DDP). Substance abuse/addiction is associated with suicidal behavior. Although our knowledge of substance abuse/addiction and suicide behavior is increasing, we lack sufficient knowledge of suicide among DDP.
(1) To compare the rate of suicide attempts among DDP and non-DDP; (2) To determine risk factors for suicide attempts in DDP.
Analysis of 3,433 consecutive admissions: men and women aged 18-65 years in our center (06/2003-06/2005).
Of 848 DDPs' admissions, 197 (23.2%) were after suicide attempts, whereas 403 of 2558 non-DDP's admissions (15.8%) were after suicide attempts (odds ratio [OR] = 1.6; 95% confidence interval [95% CI] = 1.3 - 1.9). The OR in the multiple analysis was 1.4 [95% CI] = 1.1 - 1.8). By multivariate regression analysis, the positive result for Tetrahydrocannabinol (THC) in the urine analysis was a protective factor and a diagnosis of disorders of adult personality and behavior (according to the International Classification of Disease - 10 edition [ICD-10]) was an independent risk factor for suicide attempts.
DDP have greater risks of suicide attempts than non-DDP. A comprehensive plan of preventive interventions for multidisciplinary staff is recommended in order to reduce suicide rates in DDP.
患有精神疾病和物质滥用/成瘾的患者被称为“双重诊断患者”（DDP）。物质滥用/成瘾与自杀行为相关。尽管我们对物质滥用/成瘾和自杀行为的了解在不断增加，但我们对双重诊断患者中的自杀情况仍缺乏足够的认识。
（1）比较双重诊断患者和非双重诊断患者的自杀未遂率；（2）确定双重诊断患者自杀未遂的危险因素。
对本中心（2003年6月至2005年6月）连续收治的3433例18至65岁的男性和女性患者进行分析。
在848例双重诊断患者的入院病例中，197例（23.2%）是在自杀未遂之后，而在2558例非双重诊断患者的入院病例中，403例（15.8%）是在自杀未遂之后（优势比[OR]=1.6；95%置信区间[95%CI]=1.3 - 1.9）。多元分析中的OR为1.4[95%CI]=1.1 - 1.8）。通过多变量回归分析，尿液分析中四氢大麻酚（THC）呈阳性是一个保护因素，而成人个性和行为障碍的诊断（根据国际疾病分类第10版[ICD - 10]）是自杀未遂的一个独立危险因素。
双重诊断患者比非双重诊断患者有更高的自杀未遂风险。建议为多学科工作人员制定全面的预防性干预计划，以降低双重诊断患者的自杀率。
