Children's Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
University of Texas Southwestern Medical Center, Dallas, TX, USA.
Suicide Life Threat Behav. 2019 Feb;49(1):253-263. doi: 10.1111/sltb.12428. Epub 2017 Dec 21.
We examined hopelessness as a predictor of suicide ideation in depressed youth after acute medication treatment. A total of 158 depressed adolescents were administered the Children's Depression Rating Scale-Revised (CDRS-R) and Columbia Suicide Severity Rating Scale (C-SSRS) as part of a larger battery at baseline and at weekly visits across 6 weeks of acute fluoxetine treatment. The Beck Hopelessness Scale (BHS) was administered at baseline and week 6. A negative binomial regression model via a generalized estimating equation analysis of repeated measures was used to estimate suicide ideation over the 6 weeks of acute treatment from baseline measure of hopelessness. Depression severity and gender were included as covariates in the model. The negative binomial analysis was also conducted separately for the sample of males and females (in a gender-stratified analysis). Mean CDRS-R total scores were 60.30 ± 8.93 at baseline and 34.65 ± 10.41 at week 6. Mean baseline and week 6 BHS scores were 9.57 ± 5.51 and 5.59 ± 5.38, respectively. Per the C-SSRS, 43.04% and 83.54% reported having no suicide ideation at baseline and at week 6, respectively. The analyses revealed that baseline hopelessness was positively related to suicide ideation over treatment (p = .0027), independent of changes in depression severity. This significant finding persisted only for females (p = .0024). These results indicate the importance of early identification of hopelessness.
我们研究了在急性药物治疗后,绝望情绪对抑郁青少年自杀意念的预测作用。共有 158 名抑郁青少年在基线时接受了儿童抑郁评定量表修订版(CDRS-R)和哥伦比亚自杀严重程度评定量表(C-SSRS)的评估,作为更大的药物评估电池的一部分,并在 6 周的急性氟西汀治疗期间每周进行一次评估。贝克绝望量表(BHS)在基线和第 6 周进行了评估。通过广义估计方程分析重复测量,采用负二项回归模型来估计从基线绝望情绪到急性治疗的 6 周内的自杀意念。在模型中纳入抑郁严重程度和性别作为协变量。对男性和女性样本(性别分层分析)也进行了负二项分析。基线时的平均 CDRS-R 总分(总分)为 60.30±8.93,第 6 周时为 34.65±10.41。基线和第 6 周时的平均 BHS 分数分别为 9.57±5.51 和 5.59±5.38。根据 C-SSRS,基线时和第 6 周时分别有 43.04%和 83.54%的患者报告没有自杀意念。分析结果显示,基线时的绝望情绪与治疗期间的自杀意念呈正相关(p=.0027),与抑郁严重程度的变化无关。这一显著发现仅在女性中存在(p=.0024)。这些结果表明早期识别绝望情绪的重要性。