University of Rochester Medical Center, United States of America.
University of Rochester Medical Center, United States of America.
Gen Hosp Psychiatry. 2020 Mar-Apr;63:30-32. doi: 10.1016/j.genhosppsych.2019.02.001. Epub 2019 Feb 5.
Problematic alcohol use (PAU) is a potent risk factor for suicidal behavior yet individuals with PAU presenting to hospital with suicidal risk may receive less intensive hospital-based treatment than suicidal patients without PAU. Developing efficacious interventions for at-risk patients with PAU that may be delivered in hospital is critical, particularly for those hospitalized following a suicide attempt, a group at marked risk.
The authors identified the Attempted Suicide Short Intervention Program (ASSIP) for adaption for hospitalized suicide attempt patients with PAU because of its flexibility, brevity, and evidence of efficacy to reduce risk for suicide reattempt. After consulting with the developers of ASSIP, clinical research experts in the treatment of suicidal risk and PAU, and treatment providers of hospitalized suicide attempt patients, the authors made modifications to ASSIP to tailor it to hospitalized suicide attempt patients with PAU. Results and conclusion Our modifications to ASSIP include highlighting links between PAU and the timing of the attempt; integrating such links into the narrative story of the attempt, the written case formulation, and the homework task; and identifying concrete strategies to address PAU-related risk in the prevention plan. These modifications are the focus of an ongoing treatment development study.
问题性饮酒（PAU）是自杀行为的一个强有力的风险因素，但在医院就诊时存在自杀风险的 PAU 患者可能接受的医院为基础的治疗不如没有 PAU 的自杀患者密集。为存在 PAU 风险的患者开发有效的干预措施，这些措施可能在医院内实施，这一点至关重要，尤其是对于那些在自杀未遂后住院的患者，他们处于明显的高风险中。
作者确定了自杀未遂短期干预计划（ASSIP），以便对存在 PAU 的住院自杀未遂患者进行适应性调整，因为该计划具有灵活性、简洁性和有效性证据，可以降低自杀再尝试的风险。在与 ASSIP 的开发者、治疗自杀风险和 PAU 的临床研究专家以及住院自杀未遂患者的治疗提供者协商后，作者对 ASSIP 进行了修改，使其适应存在 PAU 的住院自杀未遂患者。结果和结论：我们对 ASSIP 的修改包括突出 PAU 与尝试时间之间的联系；将这些联系纳入尝试的叙述故事、书面病例表述和家庭作业任务中；并在预防计划中确定解决与 PAU 相关风险的具体策略。这些修改是正在进行的治疗开发研究的重点。
