Baertschi Marc, Costanza Alessandra, Richard-Lepouriel Hélène, Pompili Maurizio, Sarasin François, Weber Kerstin, Canuto Alessandra
Nant Foundation, Vaud East Psychiatric Institute, Corsier-sur-Vevey, Switzerland.
Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland.
J Affect Disord. 2017 Mar 1;210:323-331. doi: 10.1016/j.jad.2016.12.049. Epub 2017 Jan 3.
Visits to emergency departments (EDs) for suicidal ideation or a suicide attempt have increased in the past decades. Yet comprehensive models of suicide are scarce, potentially enhancing misunderstandings from health professionals. This study aimed to investigate the applicability of the interpersonal-psychological theory of suicide (IPTS) in a population visiting EDs for suicide-related issues.
Three major hypotheses formulated by the IPTS were tested in a sample of 167 individuals visiting EDs for suicidal ideation or a suicide attempt.
As predicted by the IPTS, greater levels of perceived burdensomeness (PB) were associated with presence of current suicidal ideation. However, contrary to the theory assumptions, thwarted belongingness (TB) was not predictive of current suicidal ideation (Hypothesis 1). Similarly, the interaction between PB, TB and hopelessness did not account for the transition from passive to active suicidal ideation (Hypothesis 2). The interaction between active suicidal ideation and fearlessness of death did not either predict the transition from active suicidal ideation to suicidal intent (Hypothesis 3).
The cross-sectional design limited the interpretation of causal hypotheses. Patients visiting EDs during nights and weekends were underrepresented. A general measure of hopelessness was considered, not a measure of hopelessness specifically related to PB and TB.
Although the three hypotheses were only partially verified, health professionals might consider the IPTS as useful for the management of patient with suicide-related issues. Clinical intervention based on perceived burdensomeness could notably be proposed shortly after ED admission.
在过去几十年中,因自杀意念或自杀未遂前往急诊科就诊的人数有所增加。然而,全面的自杀模型却很稀缺,这可能会加剧医护人员的误解。本研究旨在调查自杀人际心理理论(IPTS)在因自杀相关问题前往急诊科就诊的人群中的适用性。
在167名因自杀意念或自杀未遂前往急诊科就诊的个体样本中,对IPTS提出的三个主要假设进行了检验。
正如IPTS所预测的,更高水平的感知负担感(PB)与当前自杀意念的存在相关。然而,与理论假设相反,归属感受挫(TB)并不能预测当前的自杀意念(假设1)。同样,PB、TB和绝望感之间的相互作用也不能解释从被动自杀意念到主动自杀意念的转变(假设2)。主动自杀意念与对死亡的无畏之间的相互作用也不能预测从主动自杀意念到自杀意图的转变(假设3)。
横断面设计限制了对因果假设的解释。夜间和周末前往急诊科就诊的患者代表性不足。使用的是绝望感的一般测量方法,而非专门与PB和TB相关的绝望感测量方法。
尽管这三个假设仅得到部分验证,但医护人员可能会认为IPTS对管理自杀相关问题的患者有用。基于感知负担感的临床干预可在急诊科收治后不久显著提出。