Independent researcher, Frisco, TX 75034, USA.
The Department of Psychology, George Mason University, Fairfax, VA 22030, USA.
Int J Environ Res Public Health. 2019 Sep 6;16(18):3274. doi: 10.3390/ijerph16183274.
Psychiatric hospitalization for a suicide attempt (SA), rather than suicide ideation (SI) alone, is a stronger risk indicator for eventual suicide death. Yet, little is known about demographic and clinical characteristics differentiating those admitted for SA versus SI. Understanding these differences has implications for assessment and treatment. A retrospective review of electronic medical records (EMRs) was performed on service members ( = 955) admitted for SA or SI at the Walter Reed Army Medical Center between 2001-2006. Service members hospitalized for SA were younger compared to those hospitalized for SI. The proportion of women admitted for SA was significantly higher than those admitted for SI whereas their male counterparts showed the opposite pattern. Patients admitted for SA, versus SI, had significantly higher prevalence of adjustment disorder with mixed disturbance of emotion and conduct (MDEC), personality disorder not otherwise specified (PDNOS), and borderline personality disorder (BPD). Patients admitted for SI had significantly higher prevalence of adjustment disorder with depressed mood and deferred Axis II diagnosis, compared to those admitted for SA. There were no significant between-group differences in the average or median number of documented prior suicide attempts. Findings highlight the need for more standardized assessment, diagnostic decision-making, and documentation practices for all patients.
因自杀企图(SA)而住院,而非仅有自杀意念(SI),是最终自杀死亡的更强风险指标。然而,对于区分因 SA 或 SI 住院的患者的人口统计学和临床特征,人们知之甚少。了解这些差异对于评估和治疗具有重要意义。对 2001 年至 2006 年间在 Walter Reed 陆军医疗中心因 SA 或 SI 住院的 955 名军人的电子病历(EMR)进行了回顾性分析。因 SA 住院的军人比因 SI 住院的军人年轻。因 SA 住院的女性比例明显高于因 SI 住院的女性,而男性则相反。与因 SI 住院的患者相比,因 SA 住院的患者更普遍患有伴有情绪和行为混合障碍的适应障碍(MDEC)、未特指的人格障碍(PDNOS)和边缘型人格障碍(BPD)。与因 SA 住院的患者相比,因 SI 住院的患者更普遍患有伴有抑郁情绪和延迟轴 II 诊断的适应障碍。在记录的既往自杀未遂次数的平均值或中位数方面,两组之间没有显著差异。研究结果强调需要对所有患者进行更标准化的评估、诊断决策和记录实践。