Salvo Lilian, Ramírez Jordana, Castro Andrea
Servicio de Psiquiatría, Hospital Clínico Herminda Martín, Chillán, Chile.
Universidad Diego Portales, Universidad Diego Portales, Chile.
Rev Med Chil. 2019 Feb;147(2):181-189. doi: 10.4067/s0034-98872019000200181.
Depression is the most common psychiatric disorder in people with suicidal behavior. The knowledge of its risk factors should help to design preventive strategies.
To describe suicidal behavior and risk factors for attempted suicide in people with major depressive disorders (MDD).
A 12-month follow-up study was conducted in 112 outpatients at three psychiatric care centers of Ñuble, Chile, with baseline and quarterly assessments. Demographic, psychosocial and clinical factors as potential risk factors of suicide attempts, were assessed. A clinical interview with DSM-IV diagnostic criteria checklist, Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied.
Sixty seven percent of participants had suicidal ideation and 43.8% had attempted suicide. Suicide risk was significantly higher in participants with a single major depressive episode (odds ratio [OR] = 3.98; 95% confidence intervals [CI] = 1,29-12,32 p = 0.02) and those with previous suicide attempts (OR = 13.15; 95% CI = 3,87-44.7 p < 0.01). Young age, not having a partner, being unemployed, having a severe major depressive episode, having psychotic symptoms, having a personality disorder and being devoid of medical illness increased the risk of suicide attempts, but they did not reach statistical significance.
Significant risk factors should be specially considered when designing suicide preventive strategies in patients with MDD.
抑郁症是有自杀行为者中最常见的精神障碍。了解其风险因素应有助于制定预防策略。
描述重度抑郁症（MDD）患者的自杀行为及自杀未遂的风险因素。
在智利Ñuble的三个精神科护理中心对112名门诊患者进行了为期12个月的随访研究，进行基线评估和季度评估。评估了人口统计学、心理社会和临床因素作为自杀未遂的潜在风险因素。应用了符合DSM-IV诊断标准清单的临床访谈、汉密尔顿抑郁量表、威胁性经历清单和感知社会支持多维量表。
67%的参与者有自杀意念，43.8%的参与者有自杀未遂经历。单次重度抑郁发作的参与者自杀风险显著更高（优势比[OR]=3.98；95%置信区间[CI]=1.29-12.32，p=0.02），有过自杀未遂经历的参与者自杀风险也显著更高（OR=13.15；95%CI=3.87-44.7，p<0.01）。年轻、没有伴侣、失业、患有重度重度抑郁发作、有精神病症状、有人格障碍以及没有躯体疾病会增加自杀未遂风险，但未达到统计学显著性。
在为MDD患者制定自杀预防策略时，应特别考虑显著的风险因素。
