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8895例中毒患者中自杀死亡及反复中毒的临床预测因素

Clinical predictors of completed suicide and repeated self-poisoning in 8895 self-poisoning patients.

作者信息

Allgulander C, Fisher L D

机构信息

Karolinska Institute, Department of Psychiatry, Huddinge University Hospital, Sweden.

出版信息

Eur Arch Psychiatry Neurol Sci. 1990;239(4):270-6. doi: 10.1007/BF01738583.

Abstract

The diagnoses of 8895 patients who were admitted for intentional self-poisoning with psycho-active drugs were studied in order to find predictors for subsequent completed suicide and repeated self-poisoning. Automated record linkage by means of the Swedish personal identification numbers was performed between the Stockholm County inpatient registry and the cause-of-death registry. With Cox regression models, several diagnostic predictors were identified although they were generally unspecific and insensitive. This may be due both to the low base rate of suicides, and to the omission of other more powerful non-clinical predictors, such as personality traits, hopelessness and social disruption. It is concluded that secondary psychiatric prevention may still be justified, although it will be applied to large numbers of patients who will not eventually commit suicide or repeat self-poisoning.

摘要

为了找出后续自杀身亡和反复自我中毒的预测因素,对8895名因使用精神活性药物蓄意自我中毒而入院的患者的诊断情况进行了研究。借助瑞典个人身份号码,在斯德哥尔摩县住院登记处和死因登记处之间进行了自动记录链接。通过Cox回归模型,确定了几个诊断预测因素,尽管它们通常不具有特异性且不敏感。这可能是由于自杀的基础发生率较低,也可能是由于遗漏了其他更有力的非临床预测因素,如人格特质、绝望和社会混乱。得出的结论是,二级精神预防可能仍然合理,尽管它将应用于大量最终不会自杀或反复自我中毒的患者。

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