Kahn Jean-Pierre, Tubiana Alexandra, Cohen Renaud F, Carli Vladimir, Wasserman Camilla, Hoven Christina, Sarchiapone Marco, Wasserman Danuta
Centre Hospitalier Universitaire de Nancy, Hôpitaux de Brabois, Vandoeuvre les Nancy 54511, France.
Université de Lorraine, Faculté de Médecine, Vandoeuvre les Nancy 54505, France.
Int J Environ Res Public Health. 2015 Sep 30;12(10):12277-90. doi: 10.3390/ijerph121012277.
Due to early detection of mental ill-health being an important suicide preventive strategy, the multi-centre EU funded "Saving and Empowering Young Lives in Europe" (SEYLE) study compared three school-based mental health promotion programs to a control group. In France, 1007 students with a mean age of 15.2 years were recruited from 20 randomly assigned schools. This paper explores the French results of the SEYLE's two-stage screening program (ProfScreen) and of the cross-program suicidal emergency procedure. Two-hundred-thirty-five ProfScreen students were screened using 13 psychopathological and risk behaviour scales. Students considered at risk because of a positive finding on one or more scales were offered a clinical interview and, if necessary, referred for treatment. A procedure for suicidal students (emergency cases) was set up to detect emergencies in the whole cohort (n = 1007). Emergency cases were offered the same clinical interview as the ProfScreen students. The interviewers documented their reasons for referrals in a short report. 16,2% of the ProfScreen students (38/235) were referred to treatment and 2,7% of the emergency cases (27/1007) were also referred to treatment due to high suicidal risk. Frequent symptoms in those students referred for evaluation were depression, alcohol misuse, non-suicidal self-injuries (NSSI), and suicidal behaviours. According to the multivariate regression analysis of ProfScreen, the results show that the best predictors for treatment referral were NSSI (OR 2.85), alcohol misuse (OR 2.80), and depressive symptoms (OR 1.13). Analysis of the proportion for each scale of students referred to treatment showed that poor social relationships (60%), anxiety (50%), and suicidal behaviours (50%) generated the highest rate of referrals. Qualitative analysis of clinician's motivations to refer a student to mental health services revealed that depressive symptoms (51%), anxiety (38%), suicidal behaviours (40%), and negative life events (35%) were the main reasons for referrals. Thus, not only the classical psychopathological symptoms, such as depression, anxiety, and suicidal behaviours, but also negative life events and poor social relationships (especially isolation) motivate referrals for treatment.
由于早期发现心理健康问题是一项重要的自杀预防策略，由欧盟资助的多中心“拯救并赋权欧洲年轻人生命”（SEYLE）研究将三项基于学校的心理健康促进项目与一个对照组进行了比较。在法国，从20所随机分配的学校招募了1007名平均年龄为15.2岁的学生。本文探讨了SEYLE两阶段筛查项目（ProfScreen）以及跨项目自杀紧急程序在法国的结果。235名ProfScreen学生使用13种心理病理学和风险行为量表进行了筛查。因在一个或多个量表上有阳性发现而被认为有风险的学生接受了临床访谈，必要时会被转介接受治疗。为自杀学生（紧急情况）设立了一个程序，以在整个队列（n = 1007）中检测紧急情况。紧急情况的学生与ProfScreen学生接受相同的临床访谈。访谈者在一份简短报告中记录了他们转介的原因。16.2%的ProfScreen学生（38/235）被转介接受治疗，2.7%的紧急情况学生（27/1007）也因自杀风险高而被转介接受治疗。那些被转介评估的学生中常见的症状有抑郁、酒精滥用、非自杀性自伤（NSSI）和自杀行为。根据ProfScreen的多变量回归分析，结果表明治疗转介的最佳预测因素是NSSI（比值比2.85）、酒精滥用（比值比2.80）和抑郁症状（比值比1.13）。对每个量表被转介治疗的学生比例分析表明，不良社会关系（60%）、焦虑（50%）和自杀行为（50%）导致的转介率最高。对临床医生将学生转介至心理健康服务机构动机的定性分析表明，抑郁症状（51%）、焦虑（38%）、自杀行为（40%）和负面生活事件（35%）是转介的主要原因。因此，不仅是抑郁、焦虑和自杀行为等经典的心理病理学症状，还有负面生活事件和不良社会关系（尤其是孤独）促使了治疗转介。
