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创伤后应激障碍患者的自杀倾向:危险因素有哪些?

Suicidality in Persons with Post-Traumatic Stress Disorder: What Are the Risk Factors?

机构信息

Department of Psychiatry, Canton Hospital "Irfan Ljubijankić", Darivalaca krvi 67, 77000 Bihać, Bosnia and Herzegovina,

出版信息

Psychiatr Danub. 2020 Nov;32(Suppl 4):436-448.

Abstract

BACKGROUND

The results of the previous research imply that persons with post-traumatic stress disorder (PTSD) are at an increased suicide risk. Suicidality is more probable when PTSD occurs in comorbidity with other psychological disorders. The studying of potential differences and the fundamental social and physiological characteristics of suicidal and non-suicidal persons with PTSD has so far failed to produce consistent results. The objective of this article is to examine whether suicidal and non-suicidal persons with PTSD differ by demographic characteristics, the presence and the type of comorbidity with other psychological disorders and the type of traumatic experience.

SUBJECTS AND METHODS

The study included 147 participants from Bosnia and Herzegovina, 91 men and 56 women, who have been diagnosed with PTSD under the 10 revision of the International Classification of Diseases (ICD-10). Based on the suicidality status (suicidal/non-suicidal), the sample was divided into two sub-samples. For the purpose of data collection, a clinical interview and a socio-demographic questionnaire was applied during psychological clinical assessment at a psychiatric ward.

RESULTS

It has been established that suicidal and non-suicidal persons with PTSD differ by demographic characteristics, such as the educational and employment status, the presence of a history of suicide in the family, the presence and type of comorbidity with other psychiatric disorders, and the type of traumatic experience. In terms of age, gender, marital status and psychiatric heredity, no significant differences have been found relative to the suicidality status.

CONCLUSIONS

Suicidal persons with PTSD more frequently have low education, they are unemployed and have a history of suicide in the family, and they are diagnosed with comorbid psychiatric disorders, dominated by mood disorders and personality disorders, with multiple comorbid disorders combined, and with war, civilian and mixed trauma being equally present in these persons. Based on the established demographic and clinical characteristics of suicidal patients with PTSD, it is possible to improve the psychological and psychiatric assessment of suicidality in persons with PTSD, which enables adequate and timely identification of the suicide risk in this population.

摘要

背景

先前的研究结果表明,患有创伤后应激障碍(PTSD)的人自杀风险增加。当 PTSD 与其他心理障碍共病时,自杀的可能性更大。迄今为止,对自杀和非自杀 PTSD 患者的潜在差异以及基本的社会和生理特征的研究尚未产生一致的结果。本文旨在探讨 PTSD 患者的自杀和非自杀者是否存在差异,包括人口统计学特征、其他心理障碍的存在和类型以及创伤经历的类型。

受试者和方法

该研究包括来自波斯尼亚和黑塞哥维那的 147 名参与者,其中 91 名男性和 56 名女性,他们根据国际疾病分类第 10 次修订版(ICD-10)被诊断为 PTSD。根据自杀状态(自杀/非自杀),样本被分为两个亚样本。为了收集数据,在精神病病房进行心理临床评估时,采用临床访谈和社会人口学问卷。

结果

已经确定,PTSD 患者的自杀和非自杀者在人口统计学特征方面存在差异,例如教育和就业状况、家庭自杀史、其他精神障碍的存在和类型,以及创伤经历的类型。在年龄、性别、婚姻状况和精神遗传方面,与自杀状态没有发现显著差异。

结论

患有 PTSD 的自杀者受教育程度较低,失业,有家庭自杀史,并且被诊断为合并精神障碍,以心境障碍和人格障碍为主,多种合并障碍并存,战争、平民和混合创伤在这些人中同样存在。基于已确定的 PTSD 自杀患者的人口统计学和临床特征,可以改善 PTSD 患者自杀风险的心理和精神评估,从而及时识别该人群的自杀风险。

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