Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, United States.
Neurosci Biobehav Rev. 2017 Dec;83:440-450. doi: 10.1016/j.neubiorev.2017.09.019. Epub 2017 Sep 18.
We conducted a meta-analysis of neurobehavioral and neurocognitive indices of impulsivity in relation to suicidal thoughts and behaviors, as well as non-suicidal self-injury (NSSI). In our systematic review, 34 studies were identified and submitted to a random-effects meta-analysis. A small pooled effect size was observed for the association between behavioral impulsivity and NSSI (OR=1.34, p<0.05). A small-to-medium pooled effect size (OR=2.23, p<0.001) was found for the association between behavioral impulsivity and suicide attempts, and a medium-to-large pooled effect size was observed for this outcome in relation to cognitive impulsivity (OR=3.14, p<0.01). Length of time between suicide attempt and impulsivity assessment moderated the strength of the relation between impulsivity and attempts, with a large pooled effect size (OR=5.54, p<0.001) evident when the suicide attempt occurred within a month of behavioral impulsivity assessment. Studies of clinically significant NSSI temporally proximal to impulsivity assessment are needed. Longitudinal research is required to clarify the prognostic value of behavioral and cognitive impulsivity for short-term risk for self-harm.
我们对与自杀意念和行为以及非自杀性自伤（NSSI）相关的冲动的神经行为和神经认知指标进行了荟萃分析。在我们的系统评价中，确定了 34 项研究，并提交进行了随机效应荟萃分析。行为冲动与 NSSI 之间存在小的聚集效应大小（OR=1.34，p<0.05）。行为冲动与自杀企图之间存在小到中等聚集效应大小（OR=2.23，p<0.001），而认知冲动与自杀企图之间存在中等到大的聚集效应大小（OR=3.14，p<0.01）。自杀企图和冲动评估之间的时间间隔会调节冲动与企图之间的关系强度，当自杀企图发生在行为冲动评估后的一个月内时，会出现大的聚集效应大小（OR=5.54，p<0.001）。需要研究与冲动评估时间上接近的临床显著 NSSI。需要进行纵向研究，以阐明行为和认知冲动对短期自我伤害风险的预后价值。
