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鉴别频繁自杀企图者的相关特征。

Distinguishing the relevant features of frequent suicide attempters.

机构信息

Department of Psychiatry at Fundacion Jimenez Diaz Hospital and Autonoma University, Avenida Reyes Católicos 2, 28040, Madrid, Spain.

出版信息

J Psychiatr Res. 2011 May;45(5):619-25. doi: 10.1016/j.jpsychires.2010.09.017. Epub 2010 Nov 4.

Abstract

BACKGROUND

In spite of the high prevalence of suicide behaviours and the magnitude of the resultant burden, little is known about why individuals reattempt. We aim to investigate the relationships between clinical risk factors and the repetition of suicidal attempts.

METHODS

1349 suicide attempters were consecutively recruited in the Emergency Room (ER) of two academic hospitals in France and Spain. Patients were extensively assessed and demographic and clinical data obtained. Data mining was used to determine the minimal number of variables that blinded the rest in relation to the number of suicide attempts. Using this set, a probabilistic graph ranking relationships with the target variable was constructed.

RESULTS

The most common diagnoses among suicide attempters were affective disorders, followed by anxiety disorders. Risk of frequent suicide attempt was highest among middle-aged subjects, and diminished progressively with advancing age of onset at first attempt. Anxiety disorders significantly increased the risk of presenting frequent suicide attempts. Pathway analysis also indicated that frequent suicide attempts were linked to greater odds for alcohol and substance abuse disorders and more intensive treatment.

CONCLUSIONS

Novel statistical methods found several clinical features that were associated with a history of frequent suicide attempts. The identified pathways may promote new hypothesis-driven studies of suicide attempts and preventive strategies.

摘要

背景

尽管自杀行为的高发率和由此产生的巨大负担,但对于为什么个体再次尝试自杀却知之甚少。我们旨在调查临床风险因素与自杀尝试重复之间的关系。

方法

1349 名自杀未遂者连续在法国和西班牙的两家学术医院的急诊室被招募。对患者进行了广泛评估,并获得了人口统计学和临床数据。数据挖掘用于确定与自杀尝试次数相关的最少数量的变量,以使其余变量处于盲态。使用这个集合,构建了一个概率图,以对目标变量的关系进行排名。

结果

自杀未遂者中最常见的诊断是情感障碍,其次是焦虑障碍。在中年患者中,频繁自杀企图的风险最高,而首次尝试时的发病年龄逐渐增加,风险逐渐降低。焦虑障碍显著增加了出现频繁自杀企图的风险。通路分析还表明,频繁的自杀企图与酒精和物质滥用障碍的几率更高以及更密集的治疗有关。

结论

新的统计方法发现了一些与频繁自杀企图史相关的临床特征。所确定的途径可能会促进自杀企图和预防策略的新的假设驱动研究。

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