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[外展精神科急诊服务评估期间发生的自杀行为和自杀未遂]

[Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service].

作者信息

de Winter R F P, de Groot M H, van Dassen M, Deen M L, de Beurs D P

出版信息

Tijdschr Psychiatr. 2017;59(3):140-149.

Abstract

The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour.
AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague.
METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering.
RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide.
CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

摘要

外展紧急精神科服务在识别、安排干预措施以及预防自杀和自杀行为方面发挥着重要作用。然而,对于紧急医疗团队成员在面对有自杀行为的患者时所进行的评估,我们却知之甚少。

目的

描述海牙紧急精神科服务在评估过程中所揭示的患者特征、自杀念头和自杀未遂之间的关系。

方法

紧急医疗服务部门详细记录了14705次会诊情况。我们将有自杀念头的患者特征与无此类念头的患者特征进行了比较,同时也对自杀未遂患者和未自杀未遂患者的特征进行了比较。我们通过使用逻辑回归模型并对聚类进行调整来进行这些比较。

结果

32.2%的患者表现出自杀行为迹象,9.2%的患者似乎有自杀未遂的可能。自杀行为最常发生在抑郁症患者中。有自杀行为的患者比无自杀行为的患者更常被收治入院,而且他们更有可能是由全科医生或综合医院转诊而来的。药物是自杀未遂时最常用的手段。

结论

在外展紧急精神科服务的约三分之一会诊中,患者表现出自杀行为。紧急精神科服务针对自杀行为的行动和政策各不相同,且取决于可能随时间变化的因素。

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