自杀死亡前的医疗接触与自杀风险记录：陆军评估军人风险与复原力研究（陆军STARRS）的结果
Health care contact and suicide risk documentation prior to suicide death: Results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).
作者信息
Ribeiro Jessica D, Gutierrez Peter M, Joiner Thomas E, Kessler Ronald C, Petukhova Maria V, Sampson Nancy A, Stein Murray B, Ursano Robert J, Nock Matthew K
机构信息
Department of Psychology, Florida State University.
Department of Psychiatry, University of Colorado School of Medicine.
出版信息
J Consult Clin Psychol. 2017 Apr;85(4):403-408. doi: 10.1037/ccp0000178.
OBJECTIVE
Prior research has shown that a substantial portion of suicide decedents access health care in the weeks and months before their death. We examined whether this is true among soldiers.
METHOD
The sample included the 569 Regular Army soldiers in the U.S. Army who died by suicide on active duty between 2004 and 2009 compared to 5,690 matched controls. Analyses examined the prevalence and frequency of health care contacts and documentation of suicide risk (i.e., the presence of prior suicidal thoughts and behaviors) over the year preceding suicide death. Predictors of health care contact and suicide risk documentation were also examined.
RESULTS
Approximately 50% of suicide decedents accessed health care in the month prior to their death, and over 25% of suicide decedents accessed health care in the week prior to their death. Mental health encounters were significantly more prevalent among suicide decedents (4 weeks: 27.9% vs. 7.9%, χ2 = 96.2, p < .001; 52 weeks: 59.4% vs. 33.7%, χ2 = 120.2, p < .001). Despite this, risk documentation was rare among suicide decedents (4 weeks: 13.8%; 52 weeks: 24.5%). Suicide decedents who were male, never married, and non-Hispanic Black were less likely to access care prior to death. Number of mental health encounters was the only predictor of suicide risk documentation among decedents at 4 weeks (OR = 1.14) and 52 weeks (OR = 1.05) prior to their death.
CONCLUSIONS
Many soldiers who die by suicide access health care shortly before death, presenting an opportunity for suicide prevention. However, in most cases, there was no documentation of prior suicidal thoughts or behaviors, highlighting the need for improvements in risk detection and prediction. Increasing the frequency, scope, and accuracy of risk assessments, especially in mental health care settings, may be particularly useful. (PsycINFO Database Record
目的
先前的研究表明，相当一部分自杀死亡者在其死亡前的数周和数月内接受过医疗保健服务。我们研究了这在士兵中是否属实。
方法
样本包括2004年至2009年期间在美国陆军现役中自杀死亡的569名正规军士兵，并与5690名匹配的对照组进行比较。分析检查了自杀死亡前一年中医疗保健接触的患病率和频率以及自杀风险的记录（即先前自杀念头和行为的存在情况）。还检查了医疗保健接触和自杀风险记录的预测因素。
结果
约50%的自杀死亡者在死亡前一个月内接受过医疗保健服务，超过25%的自杀死亡者在死亡前一周内接受过医疗保健服务。自杀死亡者中精神健康就诊情况明显更为普遍（4周：27.9%对7.9%，χ2 = 96.2，p <.001；52周：59.4%对33.7%，χ2 = 120.2，p <.001）。尽管如此，自杀死亡者中风险记录很少见（4周：13.8%；52周：24.5%）。男性、未婚且非西班牙裔黑人的自杀死亡者在死亡前接受护理的可能性较小。在死亡前4周（OR = 1.14）和52周（OR = 1.05）时，精神健康就诊次数是死者中自杀风险记录的唯一预测因素。
结论
许多自杀死亡的士兵在死亡前不久接受了医疗保健服务，这为自杀预防提供了机会。然而，在大多数情况下，没有先前自杀念头或行为的记录，这突出了改进风险检测和预测的必要性。提高风险评估的频率、范围和准确性，尤其是在精神卫生保健环境中，可能会特别有用。（PsycINFO数据库记录）
Zotero 插件