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在一家三级急诊医院住院的自杀未遂者的临床特征、精神评估和纵向结局。

Clinical Features, Psychiatric Assessment, and Longitudinal Outcome of Suicide Attempters Admitted to a Tertiary Emergency Hospital.

出版信息

Arch Suicide Res. 2016;20(2):191-204. doi: 10.1080/13811118.2015.1004491. Epub 2015 May 11.

Abstract

The objective of this study was to characterize admissions to an emergency hospital due to suicide attempts and verify outcomes in 2 years. Data were collected from medical records and were analyzed using descriptive statistics and logistic regression. The sample consisted of 412 patients (58.7% women; mean age = 32.6 years old, SD = 14.3). Self-poisoning was the most frequent method (84.0%), and they were diagnosed mainly as depressive (40.3%) and borderline personality disorders (19.1%). Previous suicide attempts and current psychiatric treatment were reported by, respectively, 32.0% and 28.4%. Fifteen patients (3.6%, 9 males) died during hospitalization. At discharge, 79.3% were referred to community-based psychiatric services. Being male (OR = 2.11; 95% CI = 1.25-3.55), using violent methods (i.e., hanging, firearms, and knives) (OR = 1.96; 95% CI = 1.02-3.75) and psychiatric treatment history (OR = 2.58; 95% CI = 1.53-4.36) were predictors for psychiatric hospitalization. Of 258 patients followed for 2 years, 10 (3.9%) died (3 suicide), and 24 (9.3%) undertook new suicide attempts. Patients with a history of psychiatric treatment had higher risks of new suicide attempts (OR = 2.46, 95% CI = 1.07-5.65). Suicide attempters admitted to emergency hospitals exhibit severe psychiatric disorders, and despite interventions, they continue to present high risks for suicide attempts and death.

摘要

本研究旨在描述因自杀企图而入院的患者特征,并在 2 年内验证结局。数据从病历中收集,采用描述性统计和逻辑回归进行分析。样本包括 412 名患者(58.7%为女性;平均年龄为 32.6 岁,标准差为 14.3)。最常见的自杀方法是自我中毒(84.0%),主要诊断为抑郁(40.3%)和边缘型人格障碍(19.1%)。分别有 32.0%和 28.4%的患者报告有既往自杀企图和目前的精神科治疗。在住院期间,有 15 名患者(3.6%,9 名男性)死亡。出院时,79.3%的患者被转介至社区精神科服务。男性(OR=2.11;95%CI=1.25-3.55)、使用暴力手段(即上吊、枪支和刀具)(OR=1.96;95%CI=1.02-3.75)和精神科治疗史(OR=2.58;95%CI=1.53-4.36)是精神科住院的预测因素。在随访 2 年的 258 名患者中,有 10 名(3.9%)死亡(3 例自杀),24 名(9.3%)再次自杀。有精神科治疗史的患者有更高的新自杀企图风险(OR=2.46,95%CI=1.07-5.65)。因自杀企图而入住急诊医院的患者表现出严重的精神障碍,尽管进行了干预,但他们仍面临着较高的自杀企图和死亡风险。

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