Orme William H, Szczepanek Ashley E, Allen Jon G, Oldham John M, Madan Alok, Frueh B Christopher, Fowler J Christopher
Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, USA; University of Texas McGovern School of Medicine, 1941 East Rd, Houston, TX 77054, USA.
Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, USA.
J Affect Disord. 2020 Apr 1;266:492-497. doi: 10.1016/j.jad.2020.01.182. Epub 2020 Feb 1.
Despite extensive research and clinical efforts, the suicide rate in the United States continues to rise, driving the need for more research to identify latent factors that increase risk for suicide and to guide treatment decision-making.
The current study examined a large cohort (N = 1,219) of high-risk psychiatric inpatients to explore associations between personality traits and suicide-related variables measured retrospectively (lifetime history prior to hospital admission) and prospectively (at discharge and 12-month follow-up).
Lifetime suicide-related behavior (SRB: combination of ideational severity, aborted, interrupted, actual attempts, and non-suicidal self-injury) was associated with age (younger), gender (female), and elevated scores on the Personality Inventory for DSM-5 (PID-5) negative affectivity, borderline trait composite score, and five-factor model traits of conscientiousness and neuroticism. Patients who manifested persistent suicidal ideation throughout a 6-8 week inpatient treatment (n = 162; 16.9%) tended to be younger, female, and to have elevated PID-5 borderline trait composite scores. Twelve-month post-discharge SRB was predicted by elevated PID-5 borderline trait composite scores.
Personality traits accounted for a small amount of variance in the overall model, thus limiting prediction based on individual traits.
This large sample of high-risk inpatients with longitudinal outcomes provides a rare assessment of proximal personality traits in predicting lifetime SRB, persistent suicidal ideation observed during the course of a 6-8-week intensive inpatient treatment, and SRB outcomes within 12 months after discharge from hospitalization. Personality traits should be included in future attempts to create predictive algorithms that include relevant biological data (neuroimaging, genetic, microbiome).
尽管进行了广泛的研究并付出了临床努力，但美国的自杀率仍在持续上升，这促使人们需要开展更多研究，以确定增加自杀风险的潜在因素，并指导治疗决策。
本研究对一大群高危精神科住院患者（N = 1219）进行了检查，以探讨人格特质与回顾性测量（入院前的终生病史）和前瞻性测量（出院时及12个月随访时）的自杀相关变量之间的关联。
终生自杀相关行为（SRB：观念严重程度、未遂、中断、实际自杀企图和非自杀性自伤的综合情况）与年龄（较年轻）、性别（女性）以及《精神疾病诊断与统计手册》第5版人格量表（PID-5）的消极情感性、边缘性特质综合得分以及尽责性和神经质的五因素模型特质得分升高有关。在为期6 - 8周的住院治疗期间表现出持续自杀意念的患者（n = 162；16.9%）往往更年轻、为女性，且PID-5边缘性特质综合得分升高。出院后12个月的SRB可通过升高的PID-5边缘性特质综合得分进行预测。
人格特质在总体模型中所占方差比例较小，因此基于个体特质进行的预测受到限制。
这个具有纵向结果的高危住院患者大样本，为预测终生SRB、在为期6 - 8周强化住院治疗过程中观察到的持续自杀意念以及出院后12个月内的SRB结果时近端人格特质的罕见评估提供了依据。在未来创建包含相关生物学数据（神经影像学数据、遗传学数据、微生物组数据）的预测算法的尝试中，应纳入人格特质。
