Haw Camilla, Casey Deborah, Holmes Jane, Hawton Keith
Academic Centre, St Andrew's, Cliftonville, Northampton, UK.
Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK.
Suicide Life Threat Behav. 2015 Dec;45(6):732-46. doi: 10.1111/sltb.12168. Epub 2015 Apr 27.
Data from the Oxford Monitoring System for Attempted Suicide (2004-2011) were used to study hospital presentations for self-harm in which Suicidal Intent Scale (SIS) scores were obtained (N = 4,840). Regression of medians was used to control for the confounding effect of age and gender. Higher estimated median SIS scores were associated with increasing age, male gender, self-poisoning versus self-injury, multiple methods of self-harm versus self-injury alone, use of gas (mainly carbon monoxide), dangerous methods of self-injury (including hanging, gunshot), and use of alcohol as part of the act. For self-poisoning patients, there was a correlation between the number of tablets taken and the total SIS score. Compared with self-poisoning with paracetamol and paracetamol-containing compounds, self-poisoning with antipsychotics was associated with a lower median SIS score while antidepressants had the same estimated median as paracetamol. Use of alcohol within 6 hours of self-harm was associated with lower SIS scores. In conclusion, certain methods of self-harm, particularly dangerous methods of self-injury and self-poisoning with gas, were associated with high intent and should alert clinicians to potential higher risk of suicide. However, apart from use of gas, suicidal intent cannot be inferred from type of drugs used for self-poisoning.
来自牛津自杀未遂监测系统（2004 - 2011年）的数据被用于研究因自我伤害而到医院就诊的情况，其中获取了自杀意图量表（SIS）评分（N = 4840）。采用中位数回归来控制年龄和性别的混杂效应。估计的SIS中位数评分越高，与年龄增长、男性、自我中毒而非自我伤害、多种自我伤害方式而非仅自我伤害、使用气体（主要是一氧化碳）、危险的自我伤害方式（包括上吊、枪击）以及将饮酒作为行为的一部分有关。对于自我中毒患者，服用药片的数量与SIS总分之间存在相关性。与用对乙酰氨基酚及含对乙酰氨基酚的化合物进行自我中毒相比，用抗精神病药物进行自我中毒与较低的SIS中位数评分相关，而抗抑郁药的估计中位数与对乙酰氨基酚相同。在自我伤害后6小时内饮酒与较低的SIS评分相关。总之，某些自我伤害方式，特别是危险的自我伤害方式和用气体进行自我中毒，与高自杀意图相关，应提醒临床医生注意潜在的更高自杀风险。然而，除了使用气体外，不能从用于自我中毒的药物类型推断出自杀意图。
