de Winter Remco F P, Hazewinkel Mirjam C, van de Sande Roland, de Beurs Derek P, de Groot Marieke H
GGZ Rivierduinen, Institute for Mental Health, Leiden, The Netherlands.
VU Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands.
Crisis. 2020 Sep;41(5):375-382. doi: 10.1027/0227-5910/a000651. Epub 2020 Feb 8.
Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.
外展精神科急诊服务在自杀危机的各个阶段都发挥着重要作用；然而，实证评估数据却很匮乏。本研究描述了接受这些服务并陷入自杀危机的患者的特征。在5年期间，记录了精神科急诊服务评估的详细信息；共纳入14705次评估。对有/无自杀行为以及有/无自杀未遂的患者特征进行了比较。对个体患者特征的聚类情况进行了结果调整。32.2%的患者接受了自杀行为评估，其中9.2%曾试图自杀。自杀行为最常与抑郁症或适应障碍相关，这些患者由全科医生或综合医院转诊至该服务机构，而那些试图自杀的患者被全科医生转诊的可能性较小。试图自杀的患者更可能为女性，且多由综合医院转诊。服药自我中毒是最常见的自杀方式。偏差可能是由于评估遗漏或不完整所致。主要诊断基于评估时的临床观察或先前记录的主要诊断。此外，自杀行为或自杀未遂情况可能被低估了。在精神科急诊服务评估中，自杀行为很常见。有/无自杀未遂的自杀患者在人口统计学特征、主要诊断和转诊机构方面存在差异，但在治疗政策方面没有差异。约40%有/无自杀未遂的自杀患者在评估后被收治。
