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首发精神病患者的自杀思维和行为:一项为期 3 年的纵向研究结果。

Suicidal thinking and behaviours in First Episode Psychosis: Findings from a 3-year longitudinal study.

机构信息

Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia (RE), Italy.

Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma (PR), Italy.

出版信息

Early Interv Psychiatry. 2021 Jun;15(3):624-633. doi: 10.1111/eip.12994. Epub 2020 May 27.

Abstract

AIM

Suicide risk is greater at the beginning of the course of psychosis. Purpose of this research was: (a) to investigate prevalence and incidence rates of suicide attempts, suicidal thinking and completed suicide in First Episode Psychosis (FEP) help-seekers as compared with non-FEP help-seeking peers, and (b) to examine any correlation of suicidal ideation with other baseline psychopathological predictors.

METHODS

Two hundred and forty-one young people (13-35 years) were assessed with the World Health Organization Quality Of Life scale - Brief version (WHOQOL-BREF), the Beck Depression Inventory - II Edition (BDI-II) and the Comprehensive Assessment of At-Risk Mental States (CAARMS) at the enrollment and over a 36-month follow-up period. A Kaplan-Meier survival analysis to calculate cumulative incidence rates of attempted and completed suicide was used.

RESULTS

FEP patients showed more severe levels of CAARMS "Suicidality/Self-Harm" item than non-FEP peers. They also had higher 3-year incidence rates of attempted suicide (11%) and completed suicide (13%). Within the FEP total group, suicidal ideation was positively correlated with BDI-II and CAARMS "Perceptual Abnormalities" item scores, and showed negative associations with younger age and WHOQOL-BREF "Social Relationships" factor sub-score.

CONCLUSIONS

Suicidal ideation is relevant in FEP patents, supporting the routine monitoring of suicide risk in baseline assessment of adolescents and young adults with early psychosis. Suicidal thinking seems to be correlated to younger age, perceptual aberrations and depression severity, as well as to poorer quality of social relationships.

摘要

目的

精神分裂症发病初期自杀风险较高。本研究的目的是:(a)与非首发精神分裂症(FEP)求助者相比,调查首发精神分裂症(FEP)求助者自杀未遂、自杀意念和自杀死亡的发生率;(b)检查自杀意念与其他基线精神病理预测因子的相关性。

方法

241 名年轻人(13-35 岁)在入组时和 36 个月的随访期间接受了世界卫生组织生活质量量表-简明版(WHOQOL-BREF)、贝克抑郁量表第二版(BDI-II)和综合风险评估精神状态量表(CAARMS)评估。采用 Kaplan-Meier 生存分析计算自杀未遂和自杀完成的累积发生率。

结果

FEP 患者的 CAARMS“自杀/自伤”项目比非 FEP 同龄人更严重。他们在 3 年内也有更高的自杀未遂发生率(11%)和自杀死亡发生率(13%)。在 FEP 总人群中,自杀意念与 BDI-II 和 CAARMS“感知异常”项目评分呈正相关,与年龄较小和 WHOQOL-BREF“社会关系”因子分呈负相关。

结论

自杀意念在 FEP 患者中很常见,支持在青少年和年轻的首发精神分裂症患者的基线评估中常规监测自杀风险。自杀意念似乎与年龄较小、感知异常和抑郁严重程度以及较差的社会关系质量有关。

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