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在住院期间和出院后对自杀患者简明健康风险追踪自我报告 (CHRT-SR) 进行纵向研究。

A longitudinal investigation of the Concise Health Risk Tracking Self-Report (CHRT-SR) in suicidal patients during and after hospitalization.

机构信息

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.

出版信息

Psychiatry Res. 2018 Apr;262:558-565. doi: 10.1016/j.psychres.2017.09.044. Epub 2017 Sep 20.

Abstract

The Concise Health Risk Tracking Self-Report (CHRT-SR) scale is a brief self-report instrument to assess suicide risk. Initial investigations have indicated good psychometric properties in psychiatric outpatients. The aims of this paper were to examine the construct validity and factor structure of the twelve- (CHRT-SR12) and seven-item (CHRT-SR7) versions and to test if clinically expected within-person changes in suicide risk over time were measurable using the CHRT-SR in two study cohorts hospitalized for suicidal ideation or behavior: (1) patients with major depressive disorder (MDD) who participated in a psychological intervention trial, n = 65, and (2) participants with bipolar disorder or MDD in an observational study, n = 44. The CHRT-SR12 and self-report measures of hopelessness, depression, and positive psychological states were administered during admission and several times post-discharge. Both versions showed good internal consistency in inpatients and confirmed the three-factor structure (i.e., hopelessness, perceived lack of social support and active suicidal ideation and plans) found in outpatients. CHRT-SR scores had strong correlations with negative and positive affective constructs in the expected directions, and indicated decreases in suicide risk following discharge, in line with clinical expectations. The CHRT-SR12 and CHRT-SR7 are promising self-report measures for assessing suicide risk in very high-risk patient populations.

摘要

简明健康风险追踪自评量表(CHRT-SR)是一种用于评估自杀风险的简短自评工具。初步研究表明,该量表在精神科门诊患者中具有良好的心理测量学特性。本文的目的是检验十二项(CHRT-SR12)和七项(CHRT-SR7)版本的结构效度和因子结构,并检验在两个因自杀意念或行为住院的研究队列中,使用 CHRT-SR 是否可以测量自杀风险随时间的个体内变化:(1)参加心理干预试验的重性抑郁障碍(MDD)患者,n = 65;(2)双相情感障碍或 MDD 的参与者在观察性研究中,n = 44。CHRT-SR12 和绝望感、抑郁和积极心理状态的自评量表在入院时和出院后多次进行评估。两种版本在住院患者中均表现出良好的内部一致性,并在门诊患者中证实了三因素结构(即绝望感、感知缺乏社会支持以及主动自杀意念和计划)。CHRT-SR 评分与预期方向的消极和积极情感结构具有很强的相关性,并表明在出院后自杀风险降低,符合临床预期。CHRT-SR12 和 CHRT-SR7 是评估高危患者自杀风险的很有前途的自评工具。

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