Eynan Rahel, Bergmans Yvonne, Antony Jesmin, Cutcliffe John R, Harder Henry G, Ambreen Munazzah, Balderson Ken, Links Paul S
<location>Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada</location>
<location>St. Michael's Hospital, Toronto, Ontario, Canada</location>
Crisis. 2014;35(2):123-31. doi: 10.1027/0227-5910/a000233.
Participants' safety is the primary concern when conducting research with suicidal or potentially suicidal participants. The presence of suicide risk is often an exclusion criterion for research participants. Subsequently, few studies have examined the effects of research assessments on study participants' suicidality.
The purpose of this research was to examine the patterns of postassessment changes in self-harm and suicide urges of study participants who were recently discharged from an inpatient psychiatric service.
Study participants (N = 120) were recruited from patients with a lifetime history of suicidal behavior admitted with current suicidal ideation or suicide attempt to an inpatient psychiatric service and/or a crisis stabilization unit. Participants were assessed for suicidal ideation with the Suicide Ideation Scale at 1, 3, and 6 months following their discharge from hospital. The risk assessment protocol was administered at the start and at the end of each of the study follow-up assessments.
Changes in self-harm and suicide urges following study assessments were small, infrequent, and were most likely to reflect a decrease in suicidality. Similarly, participants rarely reported worsening self-control over suicidal urges, and when they did, the effect was minimal. By the end of the 6-month follow-up period, increases in self-harm and suicidal urges postassessment were not seen.
The inclusion of suicidal participants in research interviews rarely increased suicide risk. Research involving suicidal individuals is possible when study protocols are well planned and executed by trained assessors and clinicians who are able to identify participants at risk and provide intervention if necessary. The few participants that required intervention had high levels of suicide ideation and behavior at baseline and almost all reported symptoms of posttraumatic stress disorder. Further study is needed to better characterize this subgroup of participants.
在对有自杀倾向或潜在自杀倾向的参与者进行研究时，参与者的安全是首要关注点。自杀风险的存在通常是研究参与者的排除标准。因此，很少有研究考察研究评估对研究参与者自杀倾向的影响。
本研究的目的是考察近期从住院精神科出院的研究参与者在评估后自我伤害和自杀冲动的变化模式。
研究参与者（N = 120）从有自杀行为终生史且目前有自杀意念或自杀未遂而入住住院精神科服务机构和/或危机稳定单元的患者中招募。参与者在出院后1个月、3个月和6个月时用自杀意念量表评估自杀意念。在每次研究随访评估开始和结束时实施风险评估方案。
研究评估后自我伤害和自杀冲动的变化很小，不常见，且最有可能反映自杀倾向的降低。同样，参与者很少报告对自杀冲动的自我控制能力恶化，即使有这种情况，影响也很小。到6个月随访期结束时，未观察到评估后自我伤害和自杀冲动增加的情况。
将有自杀倾向的参与者纳入研究访谈很少会增加自杀风险。当研究方案由训练有素的评估人员和临床医生精心策划并执行，他们能够识别有风险的参与者并在必要时提供干预时，涉及有自杀倾向个体的研究是可行的。少数需要干预的参与者在基线时具有高水平的自杀意念和行为，几乎所有人都报告有创伤后应激障碍症状。需要进一步研究以更好地描述这一亚组参与者的特征。
