Dobson Eric T, Keeshin Brooks R, Wehry Anna M, Saldaña Shannon N, Mukkamala Lekha R, Sorter Michael T, DelBello Melissa P, Blom Thomas J, Strawn Jeffrey R
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA. E-mail:
Ann Clin Psychiatry. 2017 Nov;29(4):258-265.
Despite the high prevalence of suicidality in psychiatrically hospitalized youth, its risk factors and impact on inpatient psychopharmacologic treatment are unknown. We identified characteristics associated with suicidality in psychiatrically hospitalized youth and determined the association of suicidality with subsequent psychopharmacologic interventions.
Medical records from consecutive psychiatric admissions to a large, acute care, urban, pediatric hospital were analyzed retrospectively (N = 1,309). Demographic, clinical, and treatment-related features of suicidal and nonsuicidal youth were characterized. Logistic regression identified predictors of suicidality, and multiple comparison analyses evaluated the association between suicidality and changes to antidepressant prescribing during inpatient course.
Compared with nonsuicidal patients, inpatients who were suicidal were more likely to have a mood disorder or posttraumatic stress disorder, as well as Cannabis and alcohol use, were more commonly girls, and at least 13 years of age (all P ≤ .05). Hospitalization was shorter for suicidal patients, was more likely to be associated with antidepressant treatment (P ≤ .001), and among suicidal patients prescribed antidepressants at the time of admission, was associated with a greater likelihood of changing antidepressant treatment compared with nonsuicidal inpatients (P ≤ .05).
These findings reveal differences between suicidal and nonsuicidal psychiatrically hospitalized youth and suggest that suicidality is associated with specific pharmacologic treatment approaches within this population.
尽管在因精神疾病住院的青少年中自杀倾向普遍存在，但其风险因素以及对住院期间精神药物治疗的影响尚不清楚。我们确定了因精神疾病住院的青少年中与自杀倾向相关的特征，并确定了自杀倾向与后续精神药物干预之间的关联。
回顾性分析了一家大型城市儿科急症医院连续收治的精神科患者的病历（N = 1309）。对有自杀倾向和无自杀倾向青少年的人口统计学、临床和治疗相关特征进行了描述。逻辑回归确定了自杀倾向的预测因素，多重比较分析评估了自杀倾向与住院期间抗抑郁药物处方变化之间的关联。
与无自杀倾向的患者相比，有自杀倾向的住院患者更有可能患有情绪障碍或创伤后应激障碍，以及使用大麻和酒精，女性更为常见，且至少13岁（所有P≤0.05）。有自杀倾向的患者住院时间较短，更有可能接受抗抑郁药物治疗（P≤0.001），在入院时开具抗抑郁药物的自杀倾向患者中，与无自杀倾向的住院患者相比，更换抗抑郁药物治疗的可能性更大（P≤0.05）。
这些发现揭示了有自杀倾向和无自杀倾向的因精神疾病住院青少年之间的差异，并表明自杀倾向与该人群中特定的药物治疗方法有关。
