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一家三级医院在一年时间内对所有自杀未遂患者进行的精神科会诊。

Psychiatric consultation of all suicide-attempt patients during a one year period in a tertiary hospital.

作者信息

Cooper-Kazaz Rena

机构信息

Psychiatric Outpatient Clinic, Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel.

出版信息

Isr Med Assoc J. 2013 Aug;15(8):424-9.

Abstract

BACKGROUND

Many tertiary hospitals provide psychiatric services that treat diverse clinical situations. Most patients referred to these services following a serious suicide attempt have psychiatric diagnoses, but their unique characteristics and needs are not known.

OBJECTIVES

To examine the files of patients hospitalized in a tertiary hospital in Israel following a serious suicide attempt. Their mental conditions were determined and their unique demographic and clinical characteristics and needs compared to the other patients examined by the psychiatric service.

METHODS

The study focused on 49 consecutive patients admitted after performing a life-threatening suicide attempt. They were compared to 389 non-suicidal patients assessed by the same psychiatric service during one year.

RESULTS

Nearly half the patients hospitalized following a serious suicide attempt had only an axis II diagnosis (personality disorder). Non-violent methods of suicide were used predominantly by females, and violent methods mainly by males. All suicide attempts by Muslims used violent methods, while less than half the attempts by Jews were violent. Compared to the non-suicidal patients, the suicide-attempters group was younger and had greater representation of Jewish females and Muslim males. Compared to the non-suicidal patients, these patients required more intense psychiatric care, earlier commencement of treatment in the course of hospitalization, more psychiatric visits and treatment hours, and more referrals for further care. Several risk factors appear to be associated with a need for more intense in-hospital care and a greater need for referral: male gender, religion, method of suicide attempt (violent vs. non-violent), and the existence of a psychiatric diagnosis.

CONCLUSIONS

Suicide-attempt patients who are in need of hospitalization for further medical treatment have unique clinical characteristics and require more intense treatment provided by the Consultation-Liaison Unit.

摘要

背景

许多三级医院提供治疗各种临床情况的精神科服务。大多数因严重自杀未遂而转诊至这些服务的患者都有精神科诊断,但他们的独特特征和需求尚不清楚。

目的

检查以色列一家三级医院中因严重自杀未遂而住院的患者档案。确定他们的精神状况,并将其独特的人口统计学和临床特征及需求与精神科服务检查的其他患者进行比较。

方法

该研究聚焦于49例连续因危及生命的自杀未遂而入院的患者。将他们与同一家精神科服务在一年内评估的389例非自杀患者进行比较。

结果

近一半因严重自杀未遂而住院的患者仅有轴II诊断(人格障碍)。女性主要使用非暴力自杀方式,男性主要使用暴力方式。所有穆斯林的自杀未遂都使用暴力方式,而犹太人群体中不到一半的自杀未遂是暴力的。与非自杀患者相比,自杀未遂患者组更年轻,犹太女性和穆斯林男性的比例更高。与非自杀患者相比,这些患者需要更强化的精神科护理,在住院过程中更早开始治疗,更多的精神科就诊和治疗时间,以及更多的进一步护理转诊。几个风险因素似乎与更强化的住院护理需求和更大的转诊需求相关:男性、宗教、自杀未遂方式(暴力与非暴力)以及精神科诊断的存在。

结论

需要住院接受进一步治疗的自杀未遂患者具有独特的临床特征,需要由会诊联络科提供更强化的治疗。

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