急性自杀青少年的精神病理学特征：与出院后自杀未遂及再次住院的关联。
Psychopathology profiles of acutely suicidal adolescents: Associations with post-discharge suicide attempts and rehospitalization.
作者信息
Berona Johnny, Horwitz Adam G, Czyz Ewa K, King Cheryl A
机构信息
University of Michigan, Department of Psychology, USA; University of Michigan, Department of Psychiatry, USA.
University of Michigan, Department of Psychology, USA; University of Michigan, Department of Psychiatry, USA.
出版信息
J Affect Disord. 2017 Feb;209:97-104. doi: 10.1016/j.jad.2016.10.036. Epub 2016 Nov 18.
BACKGROUND
Suicidal adolescents are heterogeneous, which can pose difficulties in predicting suicidal behavior. The Youth Self-Report (YSR) psychopathology profiles predict the future onset of psychopathology and suicide-related outcomes. The present study examined the prevalence and correlates of YSR psychopathology profiles among suicidal adolescents and prospective associations with post-discharge rates of suicide attempts and psychiatric rehospitalization.
METHODS
Participants were acutely suicidal, psychiatrically hospitalized adolescents (N=433 at baseline; n=355 at follow-up) who were enrolled in a psychosocial intervention trial during hospitalization. Psychopathology profiles were assessed at baseline. Suicide attempts and rehospitalization were assessed for up to 12 months following discharge.
RESULTS
Latent profile analysis identified four psychopathology profiles: subclinical, primarily internalizing, and moderately and severely dysregulated. At baseline, profiles differed by history of non-suicidal self-injury (NSSI) and multiple suicide attempts (MA) as well as severity of suicide ideation, hopelessness, depressive symptoms, anxiety symptoms, substance abuse, and functional impairment. The dysregulation profiles predicted suicide attempts within 3 months post-discharge. The internalizing profile predicted suicide attempts and rehospitalization at 3 and 12 months.
LIMITATIONS
This study's participants were enrolled in a randomized trial and were predominantly female, which limit generalizability. Additionally, only a history of NSSI was assessed.
CONCLUSIONS
The dysregulation profile was overrepresented among suicidal youth and associated with impairment in several domains as well as suicide attempts shortly after discharge. Adolescents with a severe internalizing profile also reported adverse outcomes throughout the study period. Psychopathology profiles warrant further examination in terms of their potential predictive validity in relation to suicide-related outcomes.
背景
自杀的青少年具有异质性，这可能给自杀行为的预测带来困难。青少年自我报告（YSR）心理病理学概况可预测心理病理学的未来发病情况以及与自杀相关的结果。本研究调查了自杀青少年中YSR心理病理学概况的患病率及其相关因素，以及与出院后自杀未遂率和精神科再住院率的前瞻性关联。
方法
参与者为急性自杀且因精神疾病住院的青少年（基线时N = 433；随访时n = 355），他们在住院期间参加了一项社会心理干预试验。在基线时评估心理病理学概况。出院后长达12个月评估自杀未遂和再住院情况。
结果
潜在概况分析确定了四种心理病理学概况：亚临床型、主要内化型、中度和重度失调型。在基线时，各概况在非自杀性自伤（NSSI）史、多次自杀未遂（MA）以及自杀意念、绝望感、抑郁症状、焦虑症状、药物滥用和功能损害的严重程度方面存在差异。失调型概况可预测出院后3个月内的自杀未遂情况。内化型概况可预测3个月和12个月时的自杀未遂和再住院情况。
局限性
本研究的参与者参加了一项随机试验，且主要为女性，这限制了研究结果的普遍性。此外，仅评估了NSSI史。
结论
失调型概况在自杀青少年中占比过高，与多个领域的损害以及出院后不久的自杀未遂相关。具有严重内化型概况的青少年在整个研究期间也报告了不良后果。心理病理学概况在与自杀相关结果的潜在预测效度方面值得进一步研究。
Zotero 插件