Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Uchimaru, Morioka, Japan.
BMC Psychiatry. 2010 Jan 12;10:4. doi: 10.1186/1471-244X-10-4.
The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group.
The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC)", "hospitalization in the psychiatry ward (HIPW)", or "non-hospitalization (NH)", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome.
The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS), general health performance (GAS), psychiatric symptoms (BPRS), and life events (LCU), while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care.
There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a support system to convince them of the risks of attempting suicide and to take a problem-solving approach to specific issues.
在紧急情况下，对自杀未遂者的结局进行分类非常重要。本研究根据自杀未遂者就诊于急诊室的结局进行分类，旨在确定每个结局组的特征和潜在需求。
将 1348 名自杀未遂者就诊于重症监护中心或医院精神科急诊的结局分为 3 组，即“入住重症监护中心（HICCC）”“入住精神科病房（HIPW）”或“未住院（NH）”，比较这些组的身体、精神和社会特征。此外，还使用多因素逻辑回归分析提取与结局相关的因素。
男女比例为 1:2。住院组，特别是 HICCC 组，在意识障碍（JCS）、一般健康表现（GAS）、精神症状（BPRS）和生活事件（LCU）方面存在明显的生物-心理-社会问题，而大多数 NH 组患者为女性，她们因相对较轻的压力而重复自杀相关行为。HIPW 组的病例数最多，症状主要为心理问题，身体问题较轻。多因素逻辑回归分析显示，结局与身体严重程度、自杀风险因素、紧急医疗干预评估以及全面护理密切相关。
每个组都有不同的潜在需求。HICCC 组需要精神科医生全职工作，还需要社会工作者和临床心理治疗师，由多专业人员组成的医疗团队立即开始全面护理。HIPW 组需要进行心理教育以防止自杀未遂的再次发生，并提高精神科病房工作人员的物理治疗质量和管理技能。NH 组患者需要一个支持系统来使他们认识到自杀的风险，并采用解决具体问题的方法。
