Department of Psychiatry, University of Pittsburgh Medical School, Western Psychiatric Institute and Clinic, 3811 O׳Hara Street, Pittsburgh, PA 15213, United States.
Department of Psychiatry, Alpert Medical School, Brown University, 700 Butler Drive, Providence, RI 02906, United States.
Psychiatry Res. 2014 Sep 30;219(1):137-42. doi: 10.1016/j.psychres.2014.05.015. Epub 2014 May 17.
Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents׳ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective suicide events. Ninety adolescent psychiatric inpatients who were admitted for recent suicide risk, completed diagnostic interviews, assessments of history of suicidal behavior, and a self-report questionnaire of major life events at baseline. Participants were followed over the subsequent 6 months after discharge to assess stability vs. onset of suicide events. Cox proportional hazard regressions were used to predict adolescents׳ time to suicide events. Results supported hypothesis, such that only recent greater dependent events, not independent or overall events, predicted risk for prospective suicide events. This effect was specific to adolescent girls. Importantly, dependent events maintained statistical significance as a predictor of future suicide events after co-varying for the effects of several established risk factors and psychopathology. Results suggest that the tendency to generate dependent events may contribute unique additional prediction for adolescent girls׳ prospective suicide risk, and highlight the need for future work in this area.
有自杀行为史的青少年特别容易再次自杀,尤其是在从住院精神病院出院后。这项研究首次测试了青少年产生压力的倾向,或者报告更多他们参与的依赖事件,是否可以预测未来的自杀事件。90 名因最近自杀风险而住院的青少年精神病患者在基线时完成了诊断访谈、自杀行为史评估以及主要生活事件的自我报告问卷。在出院后的接下来 6 个月内对参与者进行随访,以评估自杀事件的稳定性或发作。Cox 比例风险回归用于预测青少年的自杀事件时间。结果支持假设,即只有最近更多的依赖事件,而不是独立或整体事件,预测了未来自杀事件的风险。这种影响仅在女性青少年中存在。重要的是,在考虑了几个既定风险因素和精神病理学的影响后,依赖事件仍然是未来自杀事件的预测因素。研究结果表明,产生依赖事件的倾向可能会对女性青少年未来的自杀风险提供独特的额外预测,这突显了该领域未来工作的必要性。