Gjelsvik Bergljot, Heyerdahl Fridtjof, Holmes Jane, Lunn Daniel, Hawton Keith
Department of Psychology, University of Oslo, Oslo, Norway.
Oxford Mindfulness Centre and Centre for Suicide Research, Department of Psychiatry, University of Oxford, United Kingdom.
Suicide Life Threat Behav. 2017 Apr;47(2):228-241. doi: 10.1111/sltb.12278. Epub 2016 Jul 15.
Lifetime worst-point suicidality is associated with risk of subsequent death by suicide. Yet little is known about how people who deliberately self-poison (DSP) change their appraisal of suicidal intent of a single DSP episode over time. We assessed whether suicidal intent for a single index episode of DSP changed over time and factors associated with such change. We studied 202 patients admitted for DSP (66.3% female, all Caucasian), 18-85 years old (M = 37.8, SD = 14.8), using a longitudinal design (0, 3, and 12 months). The primary outcome measure was change in suicidal intent for a single index DSP episode, analyzed using multilevel modeling. Wish to die and whether the episode was considered a suicide attempt increased significantly with depressed mood. Wish to die associated with the index episode also increased over time independently of depressed mood. No association with time or depressed mood was found for perceived likelihood of dying. Depressed mood was strongly associated with appraisal of suicidal intent associated with a DSP episode. In suicide risk assessment, reports of the nature and severity of past DSP should be interpreted in light of current mood.
终生最严重的自杀倾向与随后自杀死亡的风险相关。然而，对于故意自我中毒（DSP）的人如何随着时间推移改变对单次DSP发作的自杀意图评估，人们知之甚少。我们评估了单次DSP索引发作的自杀意图是否随时间变化以及与这种变化相关的因素。我们采用纵向设计（0、3和12个月）研究了202例因DSP入院的患者（66.3%为女性，均为白种人），年龄在18 - 85岁之间（M = 37.8，SD = 14.8）。主要结局指标是单次索引DSP发作的自杀意图变化，采用多层次模型进行分析。想死的意愿以及该发作是否被视为自杀未遂随抑郁情绪显著增加。与索引发作相关的想死意愿也随时间独立于抑郁情绪而增加。未发现与时间或抑郁情绪与感知的死亡可能性相关。抑郁情绪与DSP发作相关的自杀意图评估密切相关。在自杀风险评估中，应根据当前情绪来解释过去DSP的性质和严重程度报告。
