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在精神科急诊科就诊的自杀患者中生命意义的存在与探索结构

The Presence and the Search Constructs of Meaning in Life in Suicidal Patients Attending a Psychiatric Emergency Department.

作者信息

Costanza Alessandra, Baertschi Marc, Richard-Lepouriel Hélène, Weber Kerstin, Pompili Maurizio, Canuto Alessandra

机构信息

Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.

Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.

出版信息

Front Psychiatry. 2020 Apr 28;11:327. doi: 10.3389/fpsyt.2020.00327. eCollection 2020.

Abstract

Meaning in Life (MiL) is considered protective against suicidal behavior (SB). However, few studies specifically addressed the role of the constructs, "presence of MiL" and "search for MiL," and their dynamic interplay. In this cross-sectional study of patients with SB (N = 199) visiting a psychiatric Emergency Department for either suicidal ideation (SI) or suicide attempt (SA), we pursued the following objectives: 1) to explore the relationship between the two constructs; 2) to verify the protective value of presence of MiL on SB; and 3) to assess the influence of search for MiL on the relationship between presence of MiL and SI. The two constructs were found to be independent of one another. Higher presence of MiL was globally associated with lower SB levels, particularly SI. Search for MiL was not related to SB and did not moderate the relationship between presence of MiL and SI. In conclusion, formal support for the role of presence of MiL against SB in a psychiatric sample was demonstrated. These findings, with a view toward refinement of SB risk assessment and new psychotherapeutic approaches, may lead to an enrichment of the dialogue with suicidal patients to help alleviate their unbearable suffering. Our conclusions must be replicated in psychiatric clinical populations in settings other than a psychiatric ED and by using a longitudinal prospective and case-control study design.

摘要

生活意义(MiL)被认为对自杀行为(SB)具有保护作用。然而,很少有研究专门探讨“存在生活意义”和“探寻生活意义”这两个概念的作用及其动态相互作用。在这项对因自杀意念(SI)或自杀未遂(SA)前往精神科急诊科就诊的自杀行为患者(N = 199)的横断面研究中,我们追求以下目标:1)探讨这两个概念之间的关系;2)验证存在生活意义对自杀行为的保护价值;3)评估探寻生活意义对存在生活意义与自杀意念之间关系的影响。发现这两个概念相互独立。较高的生活意义存在总体上与较低的自杀行为水平相关,尤其是自杀意念。探寻生活意义与自杀行为无关,也未调节存在生活意义与自杀意念之间的关系。总之,在精神科样本中证明了存在生活意义对自杀行为的作用得到了正式支持。这些发现,着眼于完善自杀风险评估和新的心理治疗方法,可能会丰富与自杀患者的对话,以帮助减轻他们难以忍受的痛苦。我们的结论必须在精神科急诊科以外的环境中,通过纵向前瞻性和病例对照研究设计,在精神科临床人群中进行重复验证。

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