Rodziński Paweł, Rutkowski Krzysztof, Sobański Jerzy A, Murzyn Białas Agnieszka, Cyranka Katarzyna, Grządziel Karolina, Smiatek-Mazgaj Bogna, Klasa Katarzyna, Müldner-Nieckowski Łukasz, Dembińska Edyta, Mielimąka Michał
Katedra Psychoterapii UJ CM.
Klinika Psychiatrii Dzieci i Młodzieży CM UJ.
Psychiatr Pol. 2015;49(4):847-64. doi: 10.12740/PP/OnlineFirst/32223.
Analysis of associations between symptoms reported before the beginning of the hospitalization and reduction of suicidal ideation - or its lack - obtained until the end of the hospitalization in patients of the day hospital for the treatment of neurotic and behavioral disorders.
Symptoms Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated with intensive integrative psychotherapy with predominance of psychodynamic approach in the day hospital due to neurotic, behavioral and personality disorders between 2005-2013. Percentages of patients reporting SI initially and at the end of the treatment were 29.1% and 10.2% respectively in women and 36.5% and 13.7% in men. The improvement in terms of initially reported SI was obtained by 84.3% of women and 77.5% of men. Among patients, those initially reporting SI were characterized by greater intensity of neurotic symptoms (p<0.001) and greater intensity of nearly all of 14 subtypes of neurotic symptoms(p<0.05).
Among those reporting SI, subgroups of women with greater intensity of Obsessive-compulsive symptoms (p=0.003), Neurasthenia (p=0.005), Autonomic disorders (p=0.044) and women reporting episodes of uncontrollable hunger (p<0.01) had significantly lower chances of improvement in terms of SI than others.
Patients initially reporting SI constituted approximately 1/3 in both genders and were characterized by greater intensity of neurotic disorders. Among those, women with particularly higher intensity of Obsessive-compulsive symptoms, Neurasthenia and Autonomic disorders and women reporting episodes of uncontrollable hunger seemed to suffer from SI that were more resistant to the psychotherapy. As such, those subgroups of women require special attention and diligent selection of the therapeutic methods.
分析在神经症和行为障碍日间医院接受治疗的患者中，住院开始前报告的症状与住院结束时自杀意念减轻情况（或未减轻情况）之间的关联。
2005年至2013年间，461名女性和219名男性因神经症、行为和人格障碍在日间医院接受以心理动力学方法为主的强化综合心理治疗，完成了症状清单KO“O”和生活量表。报告初始时有自杀意念和治疗结束时仍有自杀意念的女性患者比例分别为29.1%和10.2%，男性患者比例分别为36.5%和13.7%。84.3%的女性和77.5%的男性在初始报告的自杀意念方面有改善。在患者中，初始报告有自杀意念的患者表现为神经症症状强度更大（p<0.001），且几乎所有14种神经症症状亚型的强度都更大（p<0.05）。
在报告有自杀意念的患者中，强迫症状强度更大（p=0.003）、神经衰弱（p=0.005）、自主神经紊乱（p=0.044）的女性亚组以及报告有无法控制的饥饿发作的女性（p<0.01），在自杀意念改善方面的可能性明显低于其他患者。
初始报告有自杀意念的患者在两性中均约占三分之一，且具有更强的神经症障碍特征。其中，强迫症状、神经衰弱和自主神经紊乱强度特别高的女性亚组以及报告有无法控制的饥饿发作的女性，其自杀意念似乎对心理治疗更具抗性。因此，这些女性亚组需要特别关注并谨慎选择治疗方法。
