Department of Neuroscience and Mental Health, University of Milan, IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Asian J Psychiatr. 2013 Oct;6(5):421-7. doi: 10.1016/j.ajp.2013.07.001. Epub 2013 Aug 2.
Schizophrenia is associated with a significant risk of suicide: 40-50% of schizophrenic patients report suicidal ideation at some point in their lives, and 4-13% eventually commit suicide. In order to be able to predict and prevent suicide in schizophrenic patients, it is necessary to investigate and characterise suicide victims who meet the criteria for psychotic disorders and risk factors.
The aim of this retrospective study was to verify the associations between suicide attempts (SAs) and the demographic and clinical variables of 106 patients who met the DSM-IV-TR criteria for schizophrenia. The patients were divided into two groups on the basis of the presence/absence of lifetime suicide attempts, and their main demographic and clinical characteristics were analysed and compared.
The patients with a history of SAs frequently had a duration of untreated psychosis (DUP) of ≥1 year (chi-squared test=9.984, df=1, p=0.0016). They also showed significant associations with the presence of a depressive dimension (chi-squared test=4.439, df=1, p=0.0351), hospitalisations before SAs (chi-squared test=25.515, df=1, p <0.001), and a family history of psychiatric disorders (chi-squared test=12.668, df=2, p=0.0018) or suicidal behaviours (chi-squared test=18.241, df=2, p=0.0001). Finally, they were more frequently prescribed typical antipsychotic agents.
The severity of psychiatric symptoms indicates a high risk of suicide in schizophrenic patients. Further prospective studies of larger samples should investigate the role of early interventions and atypical antipsychotic treatment in reducing the risk.
精神分裂症与自杀风险显著相关:40-50%的精神分裂症患者在其一生中的某个时刻报告有自杀意念,4-13%最终自杀。为了能够预测和预防精神分裂症患者的自杀,有必要调查和描述符合精神病障碍和风险因素标准的自杀受害者。
本回顾性研究旨在验证 106 名符合 DSM-IV-TR 精神分裂症标准的患者自杀未遂(SA)与人口统计学和临床变量之间的关联。根据是否有过一生中的自杀未遂史,将患者分为两组,并对其主要人口统计学和临床特征进行分析和比较。
有自杀未遂史的患者经常存在未治疗的精神病持续时间(DUP)≥1 年(卡方检验=9.984,df=1,p=0.0016)。他们还与存在抑郁维度显著相关(卡方检验=4.439,df=1,p=0.0351),自杀未遂前的住院治疗(卡方检验=25.515,df=1,p<0.001),以及家族精神病史(卡方检验=12.668,df=2,p=0.0018)或自杀行为史(卡方检验=18.241,df=2,p=0.0001)。最后,他们更常被开典型抗精神病药物。
精神症状的严重程度表明精神分裂症患者有较高的自杀风险。应进行进一步的前瞻性研究,以调查早期干预和非典型抗精神病药物治疗在降低风险方面的作用,研究样本量应更大。