Charlifue S W, Gerhart K A
Research Department of Craig Hospital, Englewood, CO 80110.
Arch Phys Med Rehabil. 1991 Jun;72(7):488-92.
Among people with spinal cord injuries, death from suicide is two to six times more prevalent than in the general population. To determine if individual characteristics and behaviors present during rehabilitation can identify high-risk individuals, records of 5,200 spinal cord injured patients admitted to the Rocky Mountain Regional Spinal Injury System were reviewed. Of 489 deaths, 9% were due to suicide. They were compared with a control group of equal size, matched on age, gender, and injury level. The two groups differed significantly on postinjury despondency; expressions of shame, apathy, and hopelessness; and preinjury family disruption (p less than .01). They also differed on alcohol abuse, active involvement in the injury, preinjury depression or despondency, destructive behavior, and one aspect of etiology (p less than .05). Discriminant analysis yielded a predictive model that correctly classified 81% of the suicide group and 79% of the control group. Many of the demographic predictors identified in this study are similar to those reported in the scientific literature. However, when combined with specific behavioral characteristics manifested during rehabilitation, they comprise an array of variables that permits development of a clinical model for predicting suicide among persons with spinal cord injuries.
在脊髓损伤患者中，自杀死亡的发生率比普通人群高两到六倍。为了确定康复期间出现的个体特征和行为是否能够识别高危个体，研究人员对落基山地区脊髓损伤系统收治的5200例脊髓损伤患者的记录进行了回顾。在489例死亡病例中，9%是自杀所致。研究人员将这些自杀患者与一个年龄、性别和损伤程度相匹配的同等规模的对照组进行了比较。两组在伤后沮丧情绪、羞耻、冷漠和绝望情绪的表达以及伤前家庭破裂方面存在显著差异（p<0.01）。在酒精滥用、积极参与受伤过程、伤前抑郁或沮丧情绪、破坏性行为以及病因的一个方面，两组也存在差异（p<0.05）。判别分析得出了一个预测模型，该模型正确分类了81%的自杀组患者和79%的对照组患者。本研究中确定的许多人口统计学预测因素与科学文献中报道的相似。然而，当与康复期间表现出的特定行为特征相结合时，它们构成了一系列变量，从而能够开发出一种用于预测脊髓损伤患者自杀的临床模型。
