Berg John E
Department of Acute Psychiatry, Blakstad Hospital, Vestre Viken Hospital Trust, Rud, Norway.
Ment Illn. 2010 Feb 11;2(1):e3. doi: 10.4081/mi.2010.e3. eCollection 2010 Jan 25.
Prediction of increased risk of suicide is difficult. We had the opportunity to follow up 20 patients receiving electroconvulsive therapy (ECT) because of severe depression. They filled in the Antonovsky sense of coherence test (SOC) and Beck depression inventory (BDI) before and after a series of ECT treatments. Seventeen surviving patients had a mean observation time of 20.6 months, whereas the three deceased patients had 11.3 months. There was a lower mean age at onset of illness and a longer mean duration of disease in the deceased. Other clinical parameters did not differ. The surviving patients had a significant decrease on the BDI from 35 to 18 (P<0.001) and an increase on the SOC test after ECT from 2.45 to 3.19 (P<0.001), indicating both less depression and better functioning in life. The deceased had a larger change on the BDI from 32 to 13, not attaining significance because of the low number of deceased. The SOC test, however, did not increase to a purported normal level; that is, from 2.43 to 2.87. Although the SOC scale has been shown to predict mortality in substance abusers, the SOC test has not been part of earlier reviews of predictive power. Tentatively, a low pathological score on the SOC test may indicate low sense of coherence in life that might increase the propensity for suicide. These preliminary results need replication in larger studies.
预测自杀风险增加很困难。我们有机会对20名因重度抑郁症接受电休克治疗（ECT）的患者进行随访。他们在一系列ECT治疗前后填写了安托诺夫斯基连贯感测试（SOC）和贝克抑郁量表（BDI）。17名存活患者的平均观察时间为20.6个月，而3名死亡患者的平均观察时间为11.3个月。死亡患者的发病年龄较低，疾病平均持续时间较长。其他临床参数无差异。存活患者的BDI从35显著降至18（P<0.001），ECT后SOC测试从2.45升至3.19（P<0.001），表明抑郁减轻且生活功能改善。死亡患者的BDI从32变为13，变化幅度较大，但由于死亡患者数量较少未达到显著水平。然而，SOC测试并未升至所谓的正常水平，即从2.43升至2.87。尽管SOC量表已被证明可预测药物滥用者的死亡率，但SOC测试并非早期预测能力综述的一部分。初步来看，SOC测试的低病理评分可能表明生活中连贯感较低，这可能会增加自杀倾向。这些初步结果需要在更大规模的研究中进行重复验证。
