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韩国预测自杀和自杀相关行为模型队列研究:研究背景、方法学以及一项长期、大规模、多中心、前瞻性、自然主义、观察性队列研究的基线样本特征。

The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior: Study rationale, methodology, and baseline sample characteristics of a long-term, large-scale, multi-center, prospective, naturalistic, observational cohort study.

机构信息

Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.

Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.

出版信息

Compr Psychiatry. 2019 Jan;88:29-38. doi: 10.1016/j.comppsych.2018.11.003. Epub 2018 Nov 7.

Abstract

BACKGROUND

The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study is a prospective, naturalistic, observational cohort study, aiming to identify predictors of suicide attempt and suicide characteristics in the Korean suicidal population. The findings intend to contribute to a thorough understanding of suicidal phenomena and development of suicide prevention guidelines. The present cross-section study examines the study rationale, methodology, and baseline characteristics of the participants.

METHODS

Participants were enrolled via the hospital and community gateways, establishing the hospital-based cohort (HC) and community-based cohort (CC), respectively. Baseline assessment was conducted on sociodemographic, clinical, diagnostic, and psychopathological aspects. The Columbia-Suicide Severity Rating Scale was used to investigate suicidality.

RESULTS

A total of 800 suicidal people aged 15 years or older were enrolled from 8 university hospitals and 8 community mental health welfare centers (CMHWCs), among whom 480 (60%) were suicidal ideators and 320 (40%) were attempters. The ideators comprised 207 CC and 273 HC participants, whereas the attempters, 34 CC and 286 HC participants. Despite their lower severity in some measures, including suicidal ideation, compared with their HC counterparts, the CC participants within each group of ideators or attempters presented clinically significant psychopathology. Moreover, alcohol use problems and past suicide attempt were more likely to be found in CC participants. Only 11.1% to 21.6% of the participants in each of the four groups (defined by the cohorts and the ideators/attempters) were on any type of psychiatric treatment.

CONCLUSIONS

Suicidal visitors to CMHWCs need to be as closely monitored as suicidal patients in university hospitals, especially considering their association with problem drinking and past suicide attempt. A cautious assumption is that the high suicide rate in Korea might be partly attributable to the low proportion of patients receiving psychiatric services.

摘要

背景

韩国自杀预测与自杀相关行为模型队列研究(K-COMPASS)是一项前瞻性、自然主义、观察性队列研究,旨在确定韩国自杀人群中自杀企图和自杀特征的预测因素。研究结果旨在帮助我们全面了解自杀现象,并制定自杀预防指南。本横断面研究探讨了研究的基本原理、方法和参与者的基线特征。

方法

参与者通过医院和社区渠道招募,分别建立了医院队列(HC)和社区队列(CC)。基线评估包括社会人口学、临床、诊断和精神病理学方面。使用哥伦比亚自杀严重程度评定量表调查自杀意念。

结果

从 8 所大学医院和 8 个社区心理健康福利中心共招募了 800 名 15 岁及以上的自杀者,其中 480 名(60%)为有自杀意念者,320 名(40%)为企图自杀者。有自杀意念者包括 207 名 CC 和 273 名 HC 参与者,企图自杀者包括 34 名 CC 和 286 名 HC 参与者。尽管 CC 参与者在某些指标(包括自杀意念)上的严重程度较低,但与 HC 参与者相比,每个有自杀意念或企图自杀者的组内参与者均表现出显著的临床精神病理学。此外,CC 参与者更有可能存在酒精使用问题和既往自杀企图。在每个组(按队列和有自杀意念者/企图自杀者划分)中,只有 11.1%至 21.6%的参与者正在接受任何类型的精神科治疗。

结论

社区心理健康福利中心的自杀来访者需要像大学医院的自杀患者一样密切监测,尤其是考虑到他们与饮酒问题和既往自杀企图的关联。谨慎的假设是,韩国的高自杀率部分归因于接受精神科服务的患者比例较低。

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