Similä Noora, Hakko Helinä, Riipinen Pirkko, Riala Kaisa
Research Unit of Clinical Neurosciences, Department of Psychiatry, University of Oulu, Oulu, Finland.
Department of Psychiatry, Oulu University Hospital, P. O. Box 26, 90029 OYS, Oulu, Finland.
Child Psychiatry Hum Dev. 2018 Apr;49(2):225-233. doi: 10.1007/s10578-017-0744-x.
This study examined the impact of clinical and family related factors on adolescent revolving door (RD) phenomenon, defined as having three or more psychiatric hospitalizations before the age of 18. A clinical sample of adolescents (N = 508) aged 13-17 years, admitted to psychiatric inpatient care between April 2001 through March 2006, were interviewed using the k-SADS-PL and the EuropASI instruments. The national Finnish Care Register for Health Care provided life-time data on child and adolescent psychiatric inpatient hospitalizations. RD boys were shown to be significantly more likely than non-RD boys to be admitted to psychiatric inpatient care from child welfare placements and have previous self-mutilative behavior (SMB) and suicide attempts. RD girls were more likely to come from child welfare placements, have unemployed mothers and a history of SMB. Mortality in RD boys was significantly higher compared to non-RD boys. Frequent use of psychiatric inpatient care warrants comprehensive assessment of suicidal behavior in adolescents.
本研究考察了临床及家庭相关因素对青少年“旋转门”（RD）现象的影响，该现象定义为在18岁之前有三次或更多次精神病住院经历。对2001年4月至2006年3月期间入住精神病住院治疗的13至17岁青少年临床样本（N = 508），使用儿童版情感障碍和精神分裂症问卷（k-SADS-PL）及欧洲酒精和药物滥用调查（EuropASI）工具进行访谈。芬兰国家医疗保健护理登记处提供了儿童和青少年精神病住院治疗的终生数据。结果显示，与非RD男孩相比，RD男孩从儿童福利安置机构转入精神病住院治疗的可能性显著更高，且有过自残行为（SMB）和自杀未遂史。RD女孩更有可能来自儿童福利安置机构，母亲为失业状态，且有SMB病史。与非RD男孩相比，RD男孩的死亡率显著更高。频繁使用精神病住院治疗需要对青少年的自杀行为进行全面评估。
