Psychiatric Centre Copenhagen, Copenhagen, Denmark.
Early Interv Psychiatry. 2012 Aug;6(3):292-9. doi: 10.1111/j.1751-7893.2011.00284.x. Epub 2011 Aug 31.
To identify predictors for developing a higher suicidal tendency during treatment of first-episode psychosis.
In a prospective follow-up study, we examined clinical factors collected at treatment initiation as predictors for developing a higher suicidal tendency among patients in the first year of treatment of psychosis. Patients were grouped and ranked according to their highest suicidal tendency in the year before treatment: not suicidal, suicidal thoughts, suicidal plans or suicide attempt(s). Predictors for becoming more suicidal in the first year of treatment were examined on group level in multivariate logistic regression analyses. We assessed patients' suicidal tendency and clinical factors using validated interviews and rating scales. Analysis included 386 patients.
Among patients with some suicidal tendency a one-point increase score on hallucinations significantly predicted developing a higher suicidal tendency, whereas a one-point increase score on delusions was preventive of this. Feeling hopeless was highly associated with suicide attempt in those with earlier suicide attempt.
The risk of suicide attempt did not differ between patient groups with suicidal thoughts, plans or suicide attempt. In first year of treatment of psychosis, hallucinations increased the risk for becoming more suicidal, whereas delusions reduced this risk in already suicidal patients.
确定首发精神病治疗期间出现更高自杀倾向的预测因素。
在一项前瞻性随访研究中，我们研究了治疗开始时收集的临床因素，以预测精神病治疗第一年期间患者出现更高自杀倾向的情况。根据治疗前一年的最高自杀倾向，将患者分组和排序：无自杀意念、自杀意念、自杀计划或自杀企图。在多变量逻辑回归分析中，我们在组水平上检查了治疗第一年变得更具自杀倾向的预测因素。我们使用经过验证的访谈和评分量表评估了患者的自杀倾向和临床因素。分析包括 386 名患者。
在有一定自杀倾向的患者中，幻觉得分增加 1 分显著预测出现更高的自杀倾向，而妄想得分增加 1 分则可预防这种情况。感到绝望与有自杀企图的患者的自杀企图高度相关。
在有自杀意念、计划或自杀企图的患者群体中，自杀企图的风险没有差异。在精神病治疗的第一年，幻觉增加了变得更具自杀倾向的风险，而在已经有自杀倾向的患者中，妄想降低了这种风险。
