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转诊青少年的自杀意念、自杀企图和非自杀性自伤

Suicidal ideation, suicidal attempts and non-suicidal self-injuries in referred adolescent s.

机构信息

IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.

Department of Clinical and Experimental Medicine, Section of Child Neuropsychiatry, University of Sassari, Italy.

出版信息

Riv Psichiatr. 2020 May-Jun;55(3):168-174. doi: 10.1708/3382.33573.

Abstract

BACKGROUND

Specific risk factors may affect persistent suicidal ideation (SI) and suicide attempts (SA) in adolescence. Non-suicidal self-injuries (NSSIs) are possible antecedent or associated factors of suicidality.

AIMS

To compare clinical features in adolescents with mood disorders referred for severe SI and for SA, and to explore differences in those with or without NSSIs.

METHOD

22 youth with severe SI (16 males [77.3%], mean age 14.86±1.86 years), and 19 with SA (16 males [84.2%], mean age 15.05±1.75 years) were assessed for familial psychiatric disorders/suicidal attempts, traumatic antecedents, diagnosis, impulsivity, hopelessness, attitude for life and death, resilience, and according to additional NSSIs.

RESULTS

Patients with SI presented more frequent anxiety disorders, those with SA more severe suicidal ideation with plan and intention, and more duration of suicidal ideation. Resilience was lower in SI, while all the other features did not distinguish the two groups. NSSIs were found in 70.7% of the sample, without differences between groups; only impulsivity was more frequent in NSSI group.

DISCUSSION

These specific features were frequently found in this high-risk sample, but only comorbid anxiety disorders, and more active, persistent and planned suicidal ideation differentiated the two groups.

CONCLUSIONS

Patients with severe SI and SA may represent different variants of the same clinical entity. Given the high frequency of the explored features in the whole suicidal sample, this diagnostic methodology may be helpful and informative in all the high-risk adolescents with mood disorders, namely with NSSI.

摘要

背景

特定的风险因素可能会影响青少年持续的自杀意念(SI)和自杀企图(SA)。非自杀性自我伤害(NSSI)可能是自杀行为的先前或相关因素。

目的

比较因严重 SI 和 SA 而就诊的青少年患者的临床特征,并探讨有无 NSSI 的患者之间的差异。

方法

对 22 名有严重 SI(16 名男性[77.3%],平均年龄 14.86±1.86 岁)和 19 名有 SA(16 名男性[84.2%],平均年龄 15.05±1.75 岁)的青少年进行家族性精神疾病/自杀企图、创伤性诱因、诊断、冲动性、绝望感、对生死的态度、韧性评估,并根据有无附加的 NSSI 进行评估。

结果

有 SI 的患者更常患有焦虑障碍,有 SA 的患者自杀意念更严重,且有自杀意念的时间更长。SI 患者的韧性较低,而其他所有特征都无法区分两组。该样本中有 70.7%的患者存在 NSSI,两组之间无差异;只有冲动性在 NSSI 组中更常见。

讨论

这些特定特征在这一高风险样本中经常出现,但只有共患焦虑障碍,以及更活跃、持续和有计划的自杀意念可区分两组。

结论

有严重 SI 和 SA 的患者可能代表同一临床实体的不同变体。鉴于在整个自杀样本中探索到的特征的高频率,这种诊断方法可能对所有有心境障碍且有 NSSI 的高风险青少年患者有帮助和信息。

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