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抑郁多次自杀企图者 - 一种高风险表型。

Depressed Multiple-Suicide-Attempters - A High-Risk Phenotype.

机构信息

1 New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA.

2 James J. Peters Veterans' Administration Medical Center and Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

Crisis. 2017 Nov;38(6):367-375. doi: 10.1027/0227-5910/a000475. Epub 2017 Sep 15.

Abstract

BACKGROUND

There is compelling evidence that suicide attempts are among the strongest predictors of suicide and future suicide attempts.

AIM

This study aimed to examine psychopathology in multiple-suicide attempters.

METHOD

We compared the demographic and clinical features of three groups: depressed patients without a history of suicide attempts (non-attempters), depressed patients with a history of one to three suicide attempts (attempters), and depressed patients with a history of four or more suicide attempts (multiple attempters).

RESULTS

We found that attempters and multiple attempters had higher levels of depression, hopelessness, aggression, hostility, and impulsivity and were more likely to have borderline personality disorder and family history of major depression or alcohol use disorder compared with non-attempters, but did not differ between each other on these measures. Multiple attempters had greater suicidal ideation at study entry and were more likely to have family history of suicide attempt compared with attempters. Importantly, multiple attempters had greater suicide intent at the time of the most medically serious suicide attempt and more serious medical consequences during their most medically serious suicide attempt compared with attempters.

LIMITATIONS

The cross-sectional design of the study.

CONCLUSION

Our data suggest that multiple-suicide attempters require careful evaluation as their behavior can have serious medical consequences.

摘要

背景

有确凿的证据表明,自杀企图是自杀和未来自杀企图的最强预测因素之一。

目的

本研究旨在检查多次自杀企图者的精神病理学。

方法

我们比较了三组人群的人口统计学和临床特征:没有自杀企图史的抑郁症患者(非企图者)、有 1 至 3 次自杀企图史的抑郁症患者(企图者)和有 4 次或更多次自杀企图史的抑郁症患者(多次企图者)。

结果

我们发现,企图者和多次企图者的抑郁、绝望、攻击性、敌意和冲动水平更高,与非企图者相比,更有可能患有边缘型人格障碍和抑郁症或酒精使用障碍家族史,但在这些测量指标上彼此之间没有差异。多次企图者在研究开始时的自杀意念更强烈,并且更有可能有自杀企图的家族史。重要的是,多次企图者在最严重的医学上最严重的自杀企图时的自杀意图更大,并且在他们最严重的医学上最严重的自杀企图时的医疗后果更严重。

局限性

研究的横断面设计。

结论

我们的数据表明,多次自杀企图者需要仔细评估,因为他们的行为可能会产生严重的医疗后果。

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