Pedersen Charlotte Gjørup, Jensen Signe Olrik Wallenstein, Gradus Jaimie, Johnsen Søren Paaske, Mainz Jan
Psychiatr Serv. 2014 Feb 1;65(2):226-31. doi: 10.1176/appi.ps.201200021.
Systematic suicide risk assessment is recommended for patients with schizophrenia; however, little is known about the implementation of suicide risk assessment in routine clinical practice. The study aimed to determine the use of systematic suicide risk assessment at discharge and predictors of suicide attempt among hospitalized patients with schizophrenia in Denmark.
A one-year follow-up study was conducted of 9,745 patients with schizophrenia who were discharged from psychiatric wards and registered in a national population-based schizophrenia registry between 2005 and 2009.
The proportion of patients receiving suicide risk assessment at discharge from a psychiatric ward increased from 72% (95% confidence interval [CI]=71%-74%) in 2005, when the national monitoring began, to 89% (CI=89%-90%) in 2009. Within one year after discharge, 1% of all registered patients had died by suicide and 8% had attempted suicide. One out of three patients who died by suicide had no documented suicide risk assessment before discharge.
The use of systematic suicide risk assessment at discharge among patients with schizophrenia increased in Denmark between 2005 and 2009, in accordance with recommendations in national clinical guidelines and monitoring in a national clinical registry. Additional efforts are warranted to ensure a lower risk of suicidal behavior after hospital discharge.
对于精神分裂症患者，建议进行系统的自杀风险评估；然而，关于自杀风险评估在常规临床实践中的实施情况却知之甚少。本研究旨在确定丹麦住院精神分裂症患者出院时系统自杀风险评估的使用情况以及自杀未遂的预测因素。
对2005年至2009年间从精神科病房出院并登记在全国基于人群的精神分裂症登记处的9745例精神分裂症患者进行了为期一年的随访研究。
从精神科病房出院时接受自杀风险评估的患者比例从2005年全国监测开始时的72%（95%置信区间[CI]=71%-74%）增至2009年的89%（CI=89%-90%）。出院后一年内，所有登记患者中有1%自杀死亡，8%自杀未遂。自杀死亡的患者中，三分之一在出院前没有记录在案的自杀风险评估。
2005年至2009年间，丹麦精神分裂症患者出院时系统自杀风险评估的使用情况有所增加，这符合国家临床指南中的建议以及国家临床登记处的监测情况。需要做出更多努力以确保出院后自杀行为的风险更低。
