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儿童人群自杀行为复发的预测因素。

Predictors of Suicide Behavior Relapse in Pediatric Population.

机构信息

Hospital Sant Joan de Deu (Spain).

Universitat Autònoma de Barcelona (Spain).

出版信息

Span J Psychol. 2018 Mar 26;21:E6. doi: 10.1017/sjp.2018.7.

DOI:10.1017/sjp.2018.7
PMID:29576038
Abstract

Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R 2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.

摘要

识别有自杀风险的患者仍然是当今的一项挑战。据报道,有 10%的自杀未遂者最终死亡,而且随着自杀尝试次数的增加,风险和临床症状的严重程度也会增加。在有选择性和针对性的预防框架内,识别有复发风险的患者群体至关重要。本研究的目的是确定预测自杀企图复发的因素,以改善对自杀行为治疗方法的决策过程。采用的方法是纵向设计,旨在在一个包含 417 名 8 至 17 岁参与者的样本中,通过二元逻辑回归模型(逐步法)确定因素,以预测自杀行为的重复。在六个月的随访中,一个具有统计学意义的模型 χ2(3, N = 417) = 18.610;p <.001;Nagelkerke R 2 =.096 ,包括以下因素:当前人格障碍/适应不良人格诊断/OR =.806,p =.028,95%CI [1.091, 4.595],个人自残史/OR =.728,p =.043,95%CI [1.023, 4.192],以及家族精神病史/OR =.925,p =.021,95%CI [1.151, 5.530]。考虑到这些结果,有诊断为人格障碍或适应不良人格特征、有或有自残史和家族精神病史的患者,在急诊室初始干预后的六个月内,预测自杀企图复发的可能性较高。

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