Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin 9, Ireland; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels vag 12A, 17177, Stockholm, Sweden.
World Psychiatry. 2014 Jun;13(2):184-8. doi: 10.1002/wps.20131.
Psychotic experiences are far more prevalent in the population than psychotic disorders and are associated with a wide range of depressive, anxiety and behavioral disorders, as well as increased risk for psychotic disorder. Recently, psychotic experiences have been highlighted as a potentially valuable clinical marker of risk for suicidal behavior. There have been few studies to date, however, to assess psychotic experiences as a predictor of suicidality over time. We wished to assess whether young persons with suicidal ideation at baseline assessment who reported psychotic experiences were at higher risk for persistence of suicidal ideation at follow-up than young persons who also reported suicidal ideation at baseline but who did not report co-occurring psychotic experiences. A total of 2,263 adolescents were assessed at age 13 to 14 years for psychotic experiences, suicidal ideation and internalizing and externalizing psychopathology. Participants were re-assessed at ages 16 to 17 years and 19 to 20 years. Among 13- to 14-year olds with suicidal ideation, co-occurring psychotic experiences did not predict an increased odds of persistence of suicidal ideation to age 16 to 17 years (OR=0.94, 95% CI: 0.19-4.78). Among 16- to 17-year olds with suicidal ideation, however, co-occurring psychotic experiences predicted a 6-fold increased odds of persistence of suicidal ideation to age 19 to 20 years (OR=5.53, 95% CI: 1.33-23.00). Psychotic experiences are an important but under-recognized marker of risk for persistence of suicidal ideation, in particular from mid-adolescence. An increased emphasis on the clinical assessment of psychotic experiences in mental health services should be a priority.
心理体验在人群中的出现频率远高于心理障碍，并且与广泛的抑郁、焦虑和行为障碍有关，同时也增加了出现心理障碍的风险。最近，心理体验已被强调为预测自杀行为风险的一个潜在有价值的临床指标。然而，迄今为止，评估心理体验作为随时间推移的自杀性预测指标的研究很少。我们想评估在基线评估时报告有心理体验的有自杀意念的年轻人是否比那些在基线时也报告有自杀意念但没有同时报告共病心理体验的年轻人更有可能在随访时持续有自杀意念。共有 2263 名青少年在 13 至 14 岁时接受了心理体验、自杀意念以及内化和外化精神病理学的评估。参与者在 16 至 17 岁和 19 至 20 岁时接受了重新评估。在有自杀意念的 13 至 14 岁青少年中，同时出现心理体验并不能预测自杀意念持续到 16 至 17 岁的几率增加（OR=0.94，95%CI：0.19-4.78）。然而，在有自杀意念的 16 至 17 岁青少年中，同时出现心理体验预测自杀意念持续到 19 至 20 岁的几率增加了 6 倍（OR=5.53，95%CI：1.33-23.00）。心理体验是自杀意念持续存在的一个重要但未被充分认识的风险标志物，尤其是从中年到青春期后期。在精神卫生服务中，更加重视对心理体验的临床评估应该是一个优先事项。
