Brown Lily A, Armey Michael A, Sejourne Corinne, Miller Ivan W, Weinstock Lauren M
Alpert Medical School of Brown University and Butler Hospital, Providence, RI 02906, USA.
Alpert Medical School of Brown University and Butler Hospital, Providence, RI 02906, USA.
Psychiatry Res. 2016 Sep 30;243:191-7. doi: 10.1016/j.psychres.2016.06.046. Epub 2016 Jun 27.
Although the relationships between PTSD, abuse history, and suicidal behaviors are well-established in military and outpatient samples, little data is available on this relationship in inpatient samples. This study examines the relationships between these variables and related demographic and clinical correlates in a sample of psychiatric inpatients with a diagnosis of major depressive disorder using electronic medical record (EMR) data. Controlling for relevant demographic and clinical variables, PTSD diagnosis and history of abuse were both significantly associated with history of suicide attempt, but in a combined model, only history of abuse remained as a significant predictor. Whereas history of abuse was associated with a history multiple suicide attempts, PTSD diagnosis was not. Both insurance status and gender acted as significant moderators of the relationship between history of abuse and history of suicide attempt, with males and those with public/no insurance having greater associations with history of suicide attempts when an abuse history was present. These data indicate the importance of documentation of PTSD, abuse history, and history of suicide attempts. The results also suggest that in the presence of an abuse history or PTSD diagnosis, additional time spent on safety and aftercare planning following hospital discharge may be indicated.
尽管创伤后应激障碍(PTSD)、虐待史和自杀行为之间的关系在军人和门诊样本中已得到充分证实,但关于住院样本中这种关系的数据却很少。本研究利用电子病历(EMR)数据,在一组被诊断为重度抑郁症的精神科住院患者样本中,考察了这些变量之间的关系以及相关的人口统计学和临床关联因素。在控制了相关的人口统计学和临床变量后,PTSD诊断和虐待史均与自杀未遂史显著相关,但在一个综合模型中,只有虐待史仍然是一个显著的预测因素。虐待史与多次自杀未遂史相关,而PTSD诊断则不然。保险状况和性别均是虐待史与自杀未遂史之间关系的显著调节因素,当存在虐待史时,男性以及拥有公共保险/无保险的人与自杀未遂史的关联更大。这些数据表明记录PTSD、虐待史和自杀未遂史的重要性。研究结果还表明,在存在虐待史或PTSD诊断的情况下,出院后可能需要在安全和后续护理计划上花费更多时间。