意大利儿科急诊就诊的儿童和青少年的自杀行为和非自杀性自伤。
Suicidal behaviour and non-suicidal self-injury in children and adolescents seen at an Italian paediatric emergency department.
机构信息
Unità di Neuropsichiatria Infantile, Dipartimento di Neuroscience, Ospedale Pediatrico Bambino Gesù, Rome, Italy.
Unità di Neuropsichiatria Infantile, Dipartimento di Neuroscience, Ospedale Pediatrico Bambino Gesù, Rome, Italy - Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, Italy.
出版信息
Ann Ist Super Sanita. 2020 Jul-Sep;56(3):303-314. doi: 10.4415/ANN_20_03_08.
INTRODUCTION
Increasing rates of non-fatal self-harm amongst adolescents represent growing concern. The objective of the study is to describe non-fatal self-harm - including suicidal behaviour (SB), suicidal ideation (SI) and non-suicidal self-injury (NSSI) - observed at an Italian paediatric emergency department (ED).
METHODS
Retrospective analysis of the clinical records of patients admitted to ED from 2011 to 2016, who underwent child psychiatry consultation (CPc). We analyzed: rates of CPc for SB, SI and NSSI; risk factors for SB and SI in patients admitted to the hospital's Child Psychiatry Unit after a CPc; and, correlations between NSSI and SB/SI.
RESULTS
The rate of CPc for SB, SI and NSSI switched from 7.7% in 2011 to 19% in 2016, with a statistically significant increase over the years (p < 0.001), a 2.2:1 female/male ratio, and an average age of 15.5 ± 1.8 years. SB consisted mainly in drug poisoning (53%), with a significant prevalence in female. Mood disorder was identified in 82.5% of patients hospitalized for SB or SI. Substance abuse was more frequently found in patients admitted for SB when compared to the SI group. Almost half (48%) of the patients admitted for SB or SI reported a current or lifelong history of NSSI. In patients admitted for SB or SI, 3 factors were significantly and independently associated with NSSI: being female, substance abuse, and more severe depressive symptoms.
CONCLUSIONS
Between 2011 and 2016, there was a significant growing need for CP consultations for suicidal behaviours, mainly in female adolescents. The subjects admitted for SI or SB, who also presented NSSI, were mainly substance abusers, and presented with more severe depressive symptoms.
简介
青少年非致命性自伤行为发生率的上升引起了越来越多的关注。本研究旨在描述意大利儿科急诊室（ED）观察到的非致命性自伤行为，包括自杀行为（SB）、自杀意念（SI）和非自杀性自伤（NSSI）。
方法
对 2011 年至 2016 年期间因接受儿童精神病学咨询（CPc）而入住 ED 的患者的临床记录进行回顾性分析。我们分析了：CPc 用于 SB、SI 和 NSSI 的比例；CPc 后入住医院儿童精神病科病房的患者 SB 和 SI 的危险因素；以及 NSSI 与 SB/SI 之间的相关性。
结果
CPc 用于 SB、SI 和 NSSI 的比例从 2011 年的 7.7%上升到 2016 年的 19%，呈逐年显著上升趋势（p<0.001），男女比例为 2.2:1，平均年龄为 15.5±1.8 岁。SB 主要由药物中毒（53%）引起，女性中发病率显著较高。82.5%的 SB 或 SI 住院患者被诊断为情绪障碍。与 SI 组相比，SB 住院患者中更常发现物质滥用。几乎一半（48%）的 SB 或 SI 住院患者报告当前或终身有 NSSI 史。在 SB 或 SI 住院患者中，有 3 个因素与 NSSI 显著相关且独立相关：女性、物质滥用和更严重的抑郁症状。
结论
2011 年至 2016 年间，对自杀行为的 CP 咨询需求显著增加，主要是在女性青少年中。因 SI 或 SB 而住院的患者，同时存在 NSSI，主要是物质滥用者，且表现出更严重的抑郁症状。
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