Madsen Trine, van Spijker Bregje, Karstoft Karen-Inge, Nordentoft Merete, Kerkhof Ad Jfm
Copenhagen Mental Health Center, Copenhagen University Hospital, Hellerup, Denmark.
J Med Internet Res. 2016 Jun 30;18(6):e178. doi: 10.2196/jmir.5904.
Suicidal ideation (SI) is a common mental health problem. Variability in intensity of SI over time has been linked to suicidal behavior, yet little is known about the temporal course of SI.
The primary aim was to identify prototypical trajectories of SI in the general population and, secondarily, to examine whether receiving Web-based self-help for SI, psychiatric symptoms, or sociodemographics predicted membership in the identified SI trajectories.
We enrolled 236 people, from the general Dutch population seeking Web-based help for SI, in a randomized controlled trial comparing a Web-based self-help for SI group with a control group. We assessed participants at inclusion and at 2, 4, and 6 weeks. The Beck Scale for Suicide Ideation was applied at all assessments and was included in latent growth mixture modeling analysis to empirically identify trajectories.
We identified 4 SI trajectories. The high stable trajectory represented 51.7% (122/236) of participants and was characterized by constant high level of SI. The high decreasing trajectory (50/236, 21.2%) consisted of people with a high baseline SI score followed by a gradual decrease to a very low score. The third trajectory, high increasing (12/236, 5.1%), also had high initial SI score, followed by an increase to the highest level of SI at 6 weeks. The fourth trajectory, low stable (52/236, 22.0%) had a constant low level of SI. Previous attempted suicide and having received Web-based self-help for SI predicted membership in the high decreasing trajectory.
Many adults experience high persisting levels of SI, though results encouragingly indicate that receiving Web-based self-help for SI increased membership in a decreasing trajectory of SI.
自杀意念（SI）是一种常见的心理健康问题。SI强度随时间的变化与自杀行为有关，但对SI的时间进程知之甚少。
主要目的是确定普通人群中SI的典型轨迹，其次是研究接受针对SI、精神症状或社会人口统计学的基于网络的自助服务是否能预测所确定的SI轨迹中的成员资格。
我们招募了236名来自荷兰普通人群、寻求针对SI的网络帮助的人，进行一项随机对照试验，将针对SI的网络自助服务组与对照组进行比较。我们在纳入时以及第2、4和6周对参与者进行评估。在所有评估中均应用贝克自杀意念量表，并将其纳入潜在增长混合模型分析以实证确定轨迹。
我们确定了4种SI轨迹。高稳定轨迹占参与者的51.7%（122/236），其特征是SI水平持续较高。高下降轨迹（50/236，21.2%）由基线SI得分高且随后逐渐降至非常低得分的人组成。第三条轨迹，高上升轨迹（12/236，5.1%），初始SI得分也很高，随后在第6周升至SI的最高水平。第四条轨迹，低稳定轨迹（52/236，22.0%）的SI水平持续较低。既往自杀未遂以及接受针对SI的网络自助服务可预测其属于高下降轨迹。
许多成年人经历高水平的持续性SI，不过结果令人鼓舞地表明，接受针对SI的网络自助服务会增加处于SI下降轨迹中的成员比例。
