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成人自杀和自杀未遂:在精神科急诊室就诊 24 个月后对自杀风险的探索。

Suicide and suicide attempts in adults: exploring suicide risk 24 months after a psychiatric emergency room visit.

机构信息

Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal.

Departamento de Estatística, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal.

出版信息

Braz J Psychiatry. 2020 Aug;42(4):367-371. doi: 10.1590/1516-4446-2019-0583. Epub 2020 May 20.

Abstract

OBJECTIVE

Suicide risk (including attempted and completed suicide) should be measured over short periods of time after contacting health services. The objective of this study was to identify the patterns of attempted and completed suicides within 24-months of a psychiatric emergency department visit, as well as to investigate predictive risk factors, including sociodemographic and clinical variables, previous suicidal behavior, and service utilization.

METHOD

A convenience sample (n=147), recruited at a general hospital's psychiatric emergency room, included patients with suicidal ideation, suicidal plans or previous suicide attempts. These patients were followed for 24 months, focusing on two main outcomes: attempted and completed suicides.

RESULTS

After six months there were no completed suicides and 36 suicide attempts, while after 24 months there were seven completed suicides and 69 suicide attempts. A final logistic regression model for suicide attempts at 24 months identified somatic pathology and the number of previous psychiatric hospitalizations as predictive factors, with a good area under the receiver operating characteristic curve.

CONCLUSIONS

The findings showed distinct patterns of attempted and completed suicides over time, indicating the importance of a systematic multidisciplinary suicide risk evaluation in psychiatric emergency rooms.

摘要

目的

自杀风险(包括自杀未遂和自杀既遂)应在联系卫生服务机构后的短时间内进行测量。本研究的目的是在精神科急诊就诊后 24 个月内确定自杀未遂和自杀既遂的模式,并调查预测风险因素,包括社会人口学和临床变量、既往自杀行为和服务利用情况。

方法

在一家综合医院的精神科急诊室,采用方便抽样法(n=147)纳入有自杀意念、自杀计划或既往自杀未遂的患者。对这些患者进行了 24 个月的随访,重点关注两个主要结局:自杀未遂和自杀既遂。

结果

6 个月后无自杀既遂,有 36 例自杀未遂;24 个月后有 7 例自杀既遂,69 例自杀未遂。24 个月时自杀未遂的最终逻辑回归模型确定躯体病理学和既往住院次数为预测因素,受试者工作特征曲线下面积较好。

结论

研究结果显示了随时间推移自杀未遂和自杀既遂的不同模式,表明在精神科急诊室进行系统的多学科自杀风险评估的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3329/7430398/71d32337fc0f/bjp-42-04-367-g001.jpg

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