Research Centre of University Affiliated Hospital of Lévis, 143 Wolfe, Lévis, Québec, Canada.
Gen Hosp Psychiatry. 2012 Mar-Apr;34(2):178-84. doi: 10.1016/j.genhosppsych.2011.12.005. Epub 2012 Jan 27.
The present study aims to document the problem of suicidality in emergency department (ED) patients with unexplained chest pain and to assess the strength and independence of the relationship between panic and suicidal ideation (SI) in this population.
This cross-sectional study included 572 ED patients with unexplained chest pain. SI, history of suicide attempts, history of SI and the presence of thoughts about how to commit suicide were assessed. Logistic regression analyses were used to quantify the relationship between current SI and panic.
Approximately 15% [95% confidence interval (CI), 12%-18%] of patients reported current SI, and 33% (95% CI, 29%-37%) reported history of SI. Nearly 19% (95% CI, 16%-22%) of patients had thought about a method to commit suicide, and 33% (95% CI, 29%-37%) had a history of a suicide attempt. Panic attacks were diagnosed in 42% (95% CI, 38%-46%) of patients, and 45% (95% CI, 39%-51%) of those had panic disorder. Panic increased the crude likelihood of current SI [odds ratio (OR)=2.53, 1.4-4.5]. This increase in SI risk remained significant after controlling for confounding factors (OR=1.70, 95% CI, 1.0-2.9).
Suicidality and SI were common and often severe in our sample of ED patients with unexplained chest pain.
本研究旨在记录急诊科（ED）不明原因胸痛患者的自杀问题，并评估该人群中惊恐与自杀意念（SI）之间关系的强度和独立性。
本横断面研究纳入了 572 例 ED 不明原因胸痛患者。评估 SI、自杀未遂史、SI 史和关于自杀方法的想法。使用逻辑回归分析来量化当前 SI 与惊恐之间的关系。
约 15%[95%置信区间（CI），12%-18%]的患者报告有当前 SI，33%（95%CI，29%-37%）报告有 SI 史。近 19%（95%CI，16%-22%）的患者曾考虑过自杀方法，33%（95%CI，29%-37%）有自杀未遂史。42%（95%CI，38%-46%）的患者被诊断为惊恐发作，其中 45%（95%CI，39%-51%）患有惊恐障碍。惊恐增加了当前 SI 的粗发生率[比值比（OR）=2.53，1.4-4.5]。在控制混杂因素后，这种 SI 风险的增加仍然显著（OR=1.70，95%CI，1.0-2.9）。
在我们的 ED 不明原因胸痛患者样本中，自杀和 SI 很常见，且往往很严重。
