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儿科急诊科患者自述的近期生活压力源与自杀风险

Self-Reported Recent Life Stressors and Risk of Suicide in Pediatric Emergency Department Patients.

作者信息

Stanley Ian H, Snyder Deborah, Westen Sarah, Ballard Elizabeth D, Teach Stephen J, Kapetanovic Suad, Wharff Elizabeth A, Bridge Jeffrey A, Ginnis Katherine, Pao Maryland, Horowitz Lisa M

机构信息

Office of the Clinical Director National Institute of Mental Health, NIH

出版信息

Clin Pediatr Emerg Med. 2013 Mar;14(1):35-40. doi: 10.1016/j.cpem.2013.01.005.

Abstract

Emergency departments (EDs) are important venues for detecting youth at risk for suicide. Children and adolescents who present to the ED and report a recent life stressor, such as stressors related to interpersonal relationships, may be at elevated risk for suicide. Utilizing data from three large, urban pediatric EDs, we examined the relationship between reported recent life stressors and suicide risk, as measured by the Suicidal Ideation Questionnaire. Overall, youth who reported a recent life stressor were at elevated risk of suicide [adjOR = 5.43 (95% CI, 3.18-9.26)]. Importantly, however, this finding was tempered by the fact that 20% of youth who screened positive for suicide risk did not report a stressor. Thus, while the knowledge of stressors may provide useful supplementary information to a suicide risk assessment, the presence or absence of a reported stressor is not sufficient to determine one's risk of suicide. ED clinicians are advised to include direct questions about suicidal thoughts and behaviors.

摘要

急诊科是发现有自杀风险青少年的重要场所。前往急诊科就诊并报告近期生活应激源(如与人际关系相关的应激源)的儿童和青少年,自杀风险可能会升高。利用来自三个大型城市儿科急诊科的数据,我们通过自杀意念问卷研究了报告的近期生活应激源与自杀风险之间的关系。总体而言,报告近期生活应激源的青少年自杀风险升高[校正比值比=5.43(95%置信区间,3.18 - 9.26)]。然而,重要的是,20%自杀风险筛查呈阳性的青少年未报告应激源这一事实缓和了这一发现。因此,虽然了解应激源可能为自杀风险评估提供有用的补充信息,但报告的应激源的存在与否不足以确定一个人的自杀风险。建议急诊科临床医生纳入关于自杀想法和行为的直接问题。

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