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痴呆症患者的自杀意念及相关因素。

Suicidal ideation and related factors among dementia patients.

机构信息

Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

出版信息

J Affect Disord. 2015 Jun 1;178:66-70. doi: 10.1016/j.jad.2015.02.019. Epub 2015 Mar 5.

Abstract

BACKGROUND

It is generally thought that people with dementia are not able to attempt suicide because of impaired executive function. Little research is available about suicidal ideation among dementia patients. The present study examines 1) the sociodemographic and clinical features of dementia patients with suicidal ideation and 2) the effect of suicidal ideation on caregiver burden.

METHODS

A total of 634 dementia outpatients and their family caregivers participated in this study. Comparisons of variables were made among three groups: patients with suicidal ideation, patients with depression without suicidal ideation, and patients with neither suicidal ideation nor depression. Data were collected between April 2007 and July 2013.

RESULTS

Suicidal ideation was seen in 64 patients (10.1%). Patients with suicidal ideation had a significantly higher rate of behavioural and psychological symptoms of dementia (BPSD) (P<0.001). Caregivers of patients with suicidal ideation felt a higher caregiver burden, even after adjusting for BPSD score (P<0.01).

LIMITATIONS

Suicidal ideation was assessed by interview with caregivers, so we may have overlooked people who had suicidal ideation but did not express it to their caregivers.

CONCLUSIONS

Suicidal ideation among dementia patients should receive greater attention. Adequate assessment of suicidal ideation and psychological support for both patients with suicidal ideation and their caregivers are needed.

摘要

背景

人们普遍认为,痴呆患者由于执行功能受损,无法尝试自杀。关于痴呆患者自杀意念的研究很少。本研究旨在探讨:1)有自杀意念的痴呆患者的社会人口学和临床特征;2)自杀意念对照顾者负担的影响。

方法

本研究共纳入 634 名痴呆门诊患者及其家属。对有自杀意念、有抑郁但无自杀意念、既无自杀意念也无抑郁的三组患者的变量进行比较。数据收集于 2007 年 4 月至 2013 年 7 月。

结果

有 64 名患者(10.1%)存在自杀意念。有自杀意念的患者出现行为和心理症状的痴呆(BPSD)的比例显著更高(P<0.001)。即使调整了 BPSD 评分,有自杀意念患者的照顾者仍感到负担更重(P<0.01)。

局限性

自杀意念是通过与照顾者的访谈评估的,因此我们可能忽略了有自杀意念但未向照顾者表达的患者。

结论

痴呆患者的自杀意念应引起更多关注。需要对有自杀意念的患者及其照顾者进行充分的自杀意念评估和心理支持。

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