Developmental Psychiatry Section, Department of Psychiatry, Cambridge University, England, UK.
Am J Psychiatry. 2011 May;168(5):495-501. doi: 10.1176/appi.ajp.2010.10050718. Epub 2011 Feb 1.
The authors assessed whether clinical and psychosocial factors in depressed adolescents at baseline predict suicide attempts and nonsuicidal self-injury over 28 weeks of follow-up.
Participants were 164 adolescents with major depressive disorder taking part in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Clinical symptoms, family function, quality of current personal friendships, and suicidal and nonsuicidal self-harm were assessed at baseline. Suicidal and nonsuicidal self-harm thoughts and behaviors were assessed during 28 weeks of follow-up.
High suicidality, nonsuicidal self-injury, and poor family function at entry were significant independent predictors of suicide attempts over the 28 weeks of follow-up. Nonsuicidal self-injury over the follow-up period was independently predicted by nonsuicidal self-injury, hopelessness, anxiety disorder, and being younger and female at entry.
Both suicidal and nonsuicidal self-harm persisted in depressed adolescents receiving treatment in the ADAPT study. A history of nonsuicidal self-injury prior to treatment is a clinical marker for subsequent suicide attempts and should be as carefully assessed in depressed youths as current suicidal intent and behavior.
作者评估了抑郁青少年在基线时的临床和心理社会因素是否可以预测 28 周随访期间的自杀企图和非自杀性自伤。
参与青少年抑郁症抗抑郁药和心理治疗试验（ADAPT）的 164 名患有重度抑郁症的青少年为研究对象。基线时评估了临床症状、家庭功能、当前个人友谊的质量以及自杀和非自杀性自伤情况。在 28 周的随访期间评估了自杀和非自杀性自伤的想法和行为。
高自杀性、非自杀性自伤和较差的家庭功能在随访的 28 周内是自杀企图的显著独立预测因素。随访期间的非自杀性自伤由非自杀性自伤、绝望、焦虑障碍以及基线时年龄较小和女性独立预测。
接受 ADAPT 研究治疗的抑郁青少年的自杀和非自杀性自伤均持续存在。治疗前有非自杀性自伤史是随后自杀企图的临床标志，在评估抑郁青少年时应像评估当前自杀意念和行为一样仔细评估。
