Laglaoui Bakhiyi Camélia, Jaussent Isabelle, Beziat Séverine, Cohen Renaud, Genty Catherine, Kahn Jean-Pierre, Leboyer Marion, Le Vaou Pascal, Guillaume Sébastien, Courtet Philippe
Department of Emergency Psychiatry & Acute Care, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco; Inserm U1061, La Colombière Hospital, University of Montpellier, France.
Inserm U1061, La Colombière Hospital, University of Montpellier, France.
J Psychiatr Res. 2017 May;88:64-71. doi: 10.1016/j.jpsychires.2016.12.022. Epub 2017 Jan 1.
The influence of life events on suicidal behavior remains inconclusive, while reasons for living (RFL) may be protective.
To analyze the association between positive and negative life events and suicidal ideation (SI) and the interaction between life events and RFL on SI.
Patients with history of suicide attempts (n = 338) underwent a comprehensive clinical evaluation, including SI (Beck's Suicidal Ideation scale), RFL (Reasons for Living Inventory, RFLI) and life events (family, school, student or professional, social, health and religion-related and other life events) during the last twelve months.
The only negative life events associated with SI were health-related events (OR = 2.01 95%CI[1.04;3.92]). Family-related positive life events and RFL were negatively associated with SI (OR = 0.73 95%CI[0.58;0.91] and OR = 0.98 95%CI[0.97;0.98], respectively). No significant interaction between the number of positive life events and RFLI total score with current SI (p = 0.57) was detected. Family-related positive life events and RFL did not have any additive effect on SI. Positive life events did not moderate the association between health-related negative life events and SI.
This was a retrospective study, the presence of axis II disorders was not investigated and results cannot be generalized due to the sample choice (only suicide attempters).
Patients with history of suicide attempts could be less sensitive to negative life events, except for those related to health. Clinicians should pay more attention to somatic problems in patients at risk of suicide. Family support, positive psychology and therapies that strengthen RFL should be developed to prevent suicide.
生活事件对自杀行为的影响尚无定论，而生存理由可能具有保护作用。
分析正负性生活事件与自杀意念（SI）之间的关联，以及生活事件与生存理由对自杀意念的相互作用。
有自杀未遂史的患者（n = 338）接受了全面的临床评估，包括过去十二个月内的自杀意念（贝克自杀意念量表）、生存理由（生存理由量表，RFLI）和生活事件（家庭、学校、学生或职业、社交、健康及宗教相关和其他生活事件）。
与自杀意念相关的唯一负性生活事件是与健康相关的事件（OR = 2.01，95%CI[1.04;3.92]）。与家庭相关的正性生活事件和生存理由与自杀意念呈负相关（分别为OR = 0.73，95%CI[0.58;0.91]和OR = 0.98，95%CI[0.97;0.98]）。未检测到正性生活事件数量与生存理由量表总分与当前自杀意念之间的显著相互作用（p = 0.57）。与家庭相关的正性生活事件和生存理由对自杀意念没有任何相加效应。正性生活事件并未调节与健康相关的负性生活事件与自杀意念之间的关联。
这是一项回顾性研究，未调查轴II障碍的存在，且由于样本选择（仅自杀未遂者），结果不能推广。
有自杀未遂史的患者可能对负性生活事件不太敏感，但与健康相关的事件除外。临床医生应更加关注有自杀风险患者的躯体问题。应开展家庭支持、积极心理学以及强化生存理由的治疗以预防自杀。
