Pompili Maurizio, Innamorati Marco, Giupponi Giancarlo, Pycha Roger, Serafini Gianluca, Del Casale Antonio, Dominici Giovanni, Iacorossi Giulia, Forte Alberto, Girardi Nicoletta, Ferracuti Stefano, Tatarelli Roberto
Sant'Andrea Hospital, Dept. of Psychiatry, Roma, Italy.
Neuropsychiatr. 2010;24(1):56-63.
The aim of the study was to assess risk factors associated with suicidal behaviour in adult patients suffering from major mood disorders (MD) and admitted to a hospital emergency department (ED).
Participants were 283 adult patients with MDs admitted to an ED between 2006-2007. Comparisons were 675 adult patients with other DSM-IV-TR Axis I disorders. Patients undertook a complete psychiatric assessment including DSM-IV-TR diagnostic interview.
MD patients were almost 2 times more likely to have been admitted for a suicide attempt (odds ratio [OR]=1,97 [95% confidence intervals [CI]: 1,29/3,03]; p< 0,01), to report suicidal ideation at the psychiatric interview (OR=1,75 [95%CI: 1,01/3,03]; p< 0,05), than their pairs without MDs. MD patients admitted for a suicide attempt were more than 3 times more likely to report suicidal ideation at the psychiatric interview (OR=3,26 [95%CI: 1,46/7,30]; p< 0,01), than nonattempter MD patients.
Suicide behavior is one of the major reasons of use of EDs in MDs, and suicide risk is still high in the next hours after suicide attempt and admission in the ED. Therefore ED's interventions for mood disorders and suicidality must be carefully planned.
本研究旨在评估因患有重度心境障碍(MD)而入住医院急诊科(ED)的成年患者自杀行为的相关危险因素。
研究对象为2006年至2007年间入住急诊科的283例成年MD患者。对照组为675例患有其他DSM-IV-TR轴I障碍的成年患者。患者接受了包括DSM-IV-TR诊断访谈在内的全面精神科评估。
MD患者因自杀未遂入院的可能性几乎是非MD患者的2倍(优势比[OR]=1.97[95%置信区间[CI]:1.29/3.03];p<0.01),在精神科访谈中报告有自杀意念的可能性也更高(OR=1.75[95%CI:1.01/3.03];p<0.05)。因自杀未遂入院的MD患者在精神科访谈中报告有自杀意念的可能性比未尝试自杀的MD患者高出3倍多(OR=3.26[95%CI:1.46/7.30];p<0.01)。
自杀行为是MD患者使用急诊科的主要原因之一,在自杀未遂及入住急诊科后的数小时内自杀风险仍然很高。因此,必须精心规划急诊科对心境障碍和自杀行为的干预措施。