Suicide Studies Research Unit at St. Michael's Hospital, Toronto, Ontario, Canada.
Gen Hosp Psychiatry. 2012 Jan-Feb;34(1):88-97. doi: 10.1016/j.genhosppsych.2011.08.016. Epub 2011 Oct 11.
The purpose of this study is to prospectively examine the association between predictors from the three thematic areas - suicidality, personal risk factors and patient care factors - and the occurrence of postdischarge suicide ideation and behavior in recently discharged patients.
The design is a prospective cohort study of all patients admitted to an inner city inpatient psychiatric service with a lifetime history of suicidal behavior and current suicidal ideation. Predictors of suicide ideation at 1, 3 and 6 months following discharge and suicide behavior over the 6 months of follow-up were examined.
The incidence of death by suicide during the study period was 3.3% [95% confidence interval (CI)=0.9%-8.3%], and 39.4% (95% CI=30.0%-49.5%) of the surviving participants reported self-injury or suicide attempts within 6 months of hospital discharge. Risk factors such as recent suicide attempts, levels of depression, hopelessness and impulsivity were predictive of increased suicide ideation or behavior after discharge from the inpatient service.
The high risk of suicide ideation, suicide attempts and suicide demonstrated in these recently discharged patients supports the need to develop selective prevention strategies.
本研究旨在前瞻性地考察自杀意念、个人风险因素和患者护理因素这三个主题领域的预测因素与近期出院患者出院后自杀意念和行为发生的相关性。
本设计是一项对所有具有自杀行为史和当前自杀意念的市中心住院精神科服务中住院的患者进行的前瞻性队列研究。对出院后 1、3 和 6 个月自杀意念和 6 个月随访期间自杀行为的预测因素进行了检验。
在研究期间，自杀死亡的发生率为 3.3%（95%置信区间[CI]=0.9%-8.3%），39.4%（95%CI=30.0%-49.5%）的存活参与者在出院后 6 个月内报告了自我伤害或自杀企图。最近的自杀企图、抑郁程度、绝望感和冲动性等风险因素与出院后的自杀意念或行为增加相关。
这些最近出院的患者表现出的高自杀意念、自杀企图和自杀风险表明需要制定有针对性的预防策略。
