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前瞻性研究焦虑障碍患者自杀行为的危险因素。

Prospective study of risk factors for suicidal behavior in individuals with anxiety disorders.

机构信息

Department of Psychiatry and Human Behavior Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02906, USA.

出版信息

Psychol Med. 2013 Jul;43(7):1465-74. doi: 10.1017/S0033291712002504. Epub 2012 Nov 9.

Abstract

BACKGROUND

Anxiety disorders are very common and increase risk for suicide attempts. Little is known about predictors of increased risk specifically among individuals with anxiety disorders. The purpose of this study was to investigate whether specific anxiety disorders and other co-morbid psychiatric disorders, physical health, or work or social functioning increased the future likelihood of a suicide attempts among individuals with anxiety disorders. Method In this prospective study, 676 individuals with an anxiety disorder were followed for an average of 12 years.

RESULTS

As hypothesized, we found that post-traumatic stress disorder, major depressive disorder (MDD), intermittent depressive disorder (IDD), epilepsy, pain, and poor work and social functioning all predicted a shorter time to a suicide attempt in univariate analyses. In multivariate analyses, baseline MDD and IDD were independent predictors of time to suicide attempt, even when controlling for a past history of suicide attempt. No specific anxiety disorder was an independent predictor of time to attempt in this anxiety-disordered sample. Adding baseline physical health variables and social functioning did not improve the ability of the model to predict time to suicide attempt.

CONCLUSIONS

Mood disorders and past history of suicide attempts are the most powerful predictors of a future suicide attempt in this sample of individuals, all of whom have an anxiety disorder.

摘要

背景

焦虑障碍非常常见,会增加自杀企图的风险。对于哪些因素会增加特定焦虑障碍患者的风险,我们知之甚少。本研究旨在调查特定的焦虑障碍以及其他共病精神障碍、身体健康或工作或社交功能是否会增加焦虑障碍患者未来自杀企图的可能性。

方法

在这项前瞻性研究中,676 名患有焦虑障碍的患者平均随访了 12 年。

结果

正如假设的那样,我们发现创伤后应激障碍、重性抑郁障碍(MDD)、间歇性抑郁障碍(IDD)、癫痫、疼痛以及较差的工作和社交功能在单变量分析中均预测自杀企图的时间更短。在多变量分析中,基线 MDD 和 IDD 是自杀企图时间的独立预测因素,即使在控制既往自杀企图史的情况下也是如此。在这个焦虑障碍样本中,没有特定的焦虑障碍是自杀企图时间的独立预测因素。添加基线身体健康变量和社交功能并不能提高该模型预测自杀企图时间的能力。

结论

在本研究样本中,情绪障碍和既往自杀企图史是未来自杀企图的最强预测因素,所有患者均患有焦虑障碍。

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