Wei Han-Ting, Lan Wen-Hsuan, Hsu Ju-Wei, Bai Ya-Mei, Huang Kai-Lin, Su Tung-Ping, Li Cheng-Ta, Lin Wei-Chen, Chen Tzeng-Ji, Chen Mu-Hong
Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
J Pediatr. 2016 Oct;177:292-296. doi: 10.1016/j.jpeds.2016.06.057. Epub 2016 Jul 22.
To assess the independent or comorbid effect of conduct and mood disorders on the risk of suicide.
The Taiwan National Health Insurance Research Database was used to derive data for 3711 adolescents aged 12-17 years with conduct disorder and 14 844 age- and sex-matched controls between 2001 and 2009. The participants were followed up to the end of 2011, and those who attempted suicide during the follow-up period were identified.
Adolescents with conduct disorder had a higher incidence of suicide (0.9% vs 0.1%; P <.001) and attempted suicide at a younger age (17.38 ± 2.04 vs 20.52 ± 1.70 years of age) than did the controls. The Cox proportional hazards regression model, after adjustment for demographic data and psychiatric comorbidities, determined that conduct disorder was an independent risk factor for subsequent suicide attempts (hazard ratio, 5.17; 95% CI, 2.29-11.70). The sensitivity after those with other psychiatric comorbidities were excluded revealed a consistent finding (hazard ratio, 10.32; 95% CI, 3.71-28.71).
Adolescents with conduct disorder had an increased risk of suicide attempts over the next decade. Future studies are required to clarify the underlying pathophysiology and elucidate whether prompt intervention for conduct disorder could reduce this risk.
评估品行障碍和情绪障碍对自杀风险的独立影响或合并影响。
利用台湾国民健康保险研究数据库获取2001年至2009年间3711名年龄在12至17岁之间患有品行障碍的青少年以及14844名年龄和性别匹配的对照的数据。对参与者随访至2011年底，确定随访期间有自杀未遂行为的人。
患有品行障碍的青少年自杀发生率更高（0.9%对0.1%；P＜0.001），且自杀未遂的年龄更小（17.38±2.04岁对20.52±1.70岁）。在对人口统计学数据和精神科合并症进行调整后，Cox比例风险回归模型确定品行障碍是随后自杀未遂的独立危险因素（风险比，5.17；95%置信区间，2.29 - 11.70）。排除其他精神科合并症患者后的敏感性分析显示结果一致（风险比，10.32；95%置信区间，3.71 - 28.71）。
患有品行障碍的青少年在未来十年内自杀未遂的风险增加。需要进一步的研究来阐明潜在的病理生理学机制，并阐明对品行障碍的及时干预是否可以降低这种风险。
