Menon Vikas, Kattimani Shivanand, Sarkar Siddharth, Mathan Kaliaperumal
Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Department of Psychiatry, Sree Balaji Medical College and Hospitals, Chennai, Tamil Nadu, India.
J Neurosci Rural Pract. 2016 Jan-Mar;7(1):91-6. doi: 10.4103/0976-3147.168435.
Evidence indicates that repeat suicide attempters, as a group, may differ from 1(st) time attempters. The identification of repeat attempters is a powerful but underutilized clinical variable.
In this research, we aimed to compare individuals with lifetime histories of multiple attempts with 1(st) time attempters to identify factors predictive of repeat attempts.
This was a retrospective record based study carried out at a teaching cum Tertiary Care Hospital in South India.
Relevant data was extracted from the clinical records of 1(st) time attempters (n = 362) and repeat attempters (n = 61) presenting to a single Tertiary Care Center over a 4½ year period. They were compared on various sociodemographic and clinical parameters. The clinical measures included Presumptive Stressful Life Events Scale, Beck Hopelessness Scale, Coping Strategies Inventory - Short Form, and the Global Assessment of Functioning Scale.
First time attempters and repeaters were compared using appropriate inferential statistics. Logistic regression was used to identify independent predictors of repeat attempts.
The two groups did not significantly differ on sociodemographic characteristics. Repeat attempters were more likely to have given prior hints about their act (χ(2) = 4.500, P = 0.034). In the final regression model, beck hopelessness score emerged as a significant predictor of repeat suicide attempts (odds ratio = 1.064, P = 0.020).
Among suicide attempters presenting to the hospital, the presence of hopelessness is a predictor of repeat suicide attempts, independent of clinical depression. This highlights the importance of considering hopelessness in the assessment of suicidality with a view to minimize the risk of future attempts.
有证据表明，作为一个群体，多次自杀未遂者可能与首次自杀未遂者有所不同。识别多次自杀未遂者是一个强大但未得到充分利用的临床变量。
在本研究中，我们旨在比较有多次自杀未遂史的个体与首次自杀未遂者，以确定预测多次自杀未遂的因素。
这是一项基于回顾性记录的研究，在印度南部的一家教学兼三级护理医院进行。
从4年半期间在单一三级护理中心就诊的首次自杀未遂者（n = 362）和多次自杀未遂者（n = 61）的临床记录中提取相关数据。对他们在各种社会人口统计学和临床参数方面进行比较。临床测量包括推定应激性生活事件量表、贝克绝望量表、应对策略量表简表和功能总体评定量表。
使用适当的推断统计方法对首次自杀未遂者和多次自杀未遂者进行比较。采用逻辑回归来识别多次自杀未遂的独立预测因素。
两组在社会人口统计学特征方面无显著差异。多次自杀未遂者更有可能在自杀行为之前给出过暗示（χ² = 4.500，P = 0.034）。在最终回归模型中，贝克绝望得分成为多次自杀未遂的显著预测因素（优势比 = 1.064，P = 0.020）。
在到医院就诊的自杀未遂者中，绝望情绪的存在是多次自杀未遂的一个预测因素，与临床抑郁症无关。这凸显了在自杀倾向评估中考虑绝望情绪的重要性，以期将未来自杀未遂的风险降至最低。
