Dartmouth Medical School, Hanover, NH, USA.
Psychiatry Res. 2012 May 15;197(1-2):55-9. doi: 10.1016/j.psychres.2011.11.025. Epub 2012 Mar 6.
Suicidal ideation is a risk factor for suicide attempt and completion. Cross-sectional or retrospective studies cannot capture the dynamic course and possible predictors of suicidal ideation as it occurs in daily life. This study utilizes an experience sampling paradigm to identify real-time predictors of suicidal ideation in inpatients with major depressive disorder. Thirty-one depressed patients admitted to a psychiatric unit were signaled by a mobile device to record suicidal ideation, affect, and other symptoms, multiple times a day over 1 week. Participants completed a total of 1350 questionnaires. Seventy-four percent of the sample reported suicidal ideation during the week. Time-lagged analyses revealed that momentary ratings of Sadness, Tension, and Boredom (as well as suicidal ideation itself) predicted subsequent suicidal thoughts in the following hours. Baseline severity of depression and past suicide attempts were both correlated with mean ideation severity during the week. A number of predictors identified in prior research (e.g. hopelessness) were unrelated to subsequent suicidal ideation in the current study. Momentary interventions that guide individuals through activities designed to reduce levels of Sadness, Tension, and Boredom in real-time (e.g., thought challenging, relaxation, behavioral activation) may be especially warranted.
自杀意念是自杀企图和完成的一个风险因素。横断面或回顾性研究无法捕捉到自杀意念在日常生活中的动态过程和可能的预测因素。本研究利用经验采样范式，确定了住院抑郁症患者自杀意念的实时预测因素。31 名被诊断为抑郁症的患者被移动设备提示，在一周内的一天多次记录自杀意念、情绪和其他症状。参与者共完成了 1350 份问卷。在这一周内，有 74%的样本报告了自杀意念。时滞分析显示，当下的悲伤、紧张和无聊（以及自杀意念本身）评分预测了随后几小时内的自杀想法。抑郁的基线严重程度和既往自杀企图都与该周的平均意念严重程度相关。在当前研究中，先前研究中确定的一些预测因素（例如绝望）与随后的自杀意念无关。目前特别需要实时的干预措施，引导个人参与旨在减轻悲伤、紧张和无聊的活动（例如思维挑战、放松、行为激活）。
