Blasco-Fontecilla Hilario, Artieda-Urrutia Paula, Berenguer-Elias Nuria, Garcia-Vega Juan Manuel, Fernandez-Rodriguez Monica, Rodriguez-Lomas Cesar, Gonzalez-Villalobos Isabel, Iruela-Cuadrado Luis, de Leon José
Adicciones. 2014;26(4):321-33.
The literature provides support for the hypothesis that some major repeaters (individuals with >=5 lifetime suicide attempts) are addicted to suicidal behavior (SB). This study explores whether major repeaters are addicted to SB or not using 7 criteria: tolerance (Criterion 1), withdrawal (Criterion 2), loss of control (Criterion 3), problems in quitting/cutting down (Criterion 4), much time spent using (Criterion 5), substantial reduction in activities (Criterion 6), and adverse physiological/physical consequences (Criterion 7). Total dependence on SB was indicated by the presence of 3 or more of the 7 criteria in the last 12 months. This cross-sectional study at Puerta de Hierro University Hospital (Madrid, Spain) recruited 118 suicide attempters including 8 major repeaters (7%, 8/118), who were all females. The association between each SB addiction criterion, physiological dependence and total dependence with major repeater status was tested for significance and for effect size with odds ratios (ORs) and their 95% confidence intervals. As hypothesized, major repeaters met significantly higher frequency of criteria for total dependence on SB, OR=62.9 (6.4-615). A backward stepwise logistic regression model was used to provide an OR between major repeater status and total dependence status corrected by confounding variables. Age, panic disorder without agoraphobia, borderline personality disorder, history of psychiatric inpatient admission, and total dependence on SB were introduced as independent variables with major repeater status as the dependent variable. The model selected total dependence and age as the remaining significant variables in the last step. Accordingly, major repeaters appear to be addicted to SB.
文献支持这样一种假说，即一些重度自杀未遂者（一生中有≥5次自杀未遂的个体）对自杀行为（SB）上瘾。本研究使用7项标准探讨重度自杀未遂者是否对自杀行为上瘾：耐受性（标准1）、戒断反应（标准2）、失控（标准3）、戒断/减少自杀行为的问题（标准4）、花费大量时间进行自杀行为（标准5）、活动大幅减少（标准6）以及不良生理/身体后果（标准7）。在过去12个月中出现7项标准中的3项或更多项表明对自杀行为完全依赖。这项在西班牙马德里Puerta de Hierro大学医院进行的横断面研究招募了118名自杀未遂者，其中包括8名重度自杀未遂者（7%，8/118），均为女性。对每项自杀行为成瘾标准、生理依赖以及完全依赖与重度自杀未遂者状态之间的关联进行了显著性检验，并使用优势比（OR）及其95%置信区间来评估效应大小。正如所假设的，重度自杀未遂者达到对自杀行为完全依赖标准的频率显著更高，OR = 62.9（6.4 - 615）。使用向后逐步逻辑回归模型来提供经混杂变量校正后的重度自杀未遂者状态与完全依赖状态之间的OR。将年龄、无广场恐惧症的惊恐障碍、边缘性人格障碍、精神科住院史以及对自杀行为的完全依赖作为自变量，以重度自杀未遂者状态作为因变量。该模型在最后一步选择完全依赖和年龄作为剩余的显著变量。因此，重度自杀未遂者似乎对自杀行为上瘾。
