Consultation Liaison Psychiatry Service, O'Brien Centre, St Vincent's Hospital, 394 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Discipline of Psychiatry, Faculty of Medicine, University of Notre Dame, Sydney, NSW, Australia.
BMC Psychiatry. 2020 Nov 25;20(1):560. doi: 10.1186/s12888-020-02950-0.
Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between lifetime repeated DSH and certain lifestyle factors, including balanced meals, eating breakfast, consumption of 'junk' food, weight, exercise, substance/alcohol use, smoking and social support, in a cohort of patients who presented to the Emergency Department (ED) with suicidal ideation or DSH.
From 2007 to 2016, data from lifestyle and mental health measures were collected from 448 attenders at an outpatient clinic for DSH or suicidal ideation following ED presentation. Lifestyle behaviours (Fantastic Lifestyle Checklist) and mental health (Depression and Anxiety Stress Scale), clinical diagnosis and number of previous DSH episodes were measured on arrival. The associations between lifestyle variables and the number of lifetime DSH episodes were examined.
Sex, age, depression symptoms, poor diet, and smoking were all associated with a higher average number of deliberate self-harm episodes across the lifespan. There were non-significant positive trends for the other poor lifestyle behaviours. There was no association between DSH episodes and diagnosis of depression or anxiety disorder. In a multiple linear regression model, the only factors that remained significant were age, smoking and eating balanced meals, however, the relationship between smoking and lifetime DSH was moderated by more immediate DSH behaviours.
In this sample of patients referred to a service following presentation to the ED with acute mental health concerns, balanced meals and smoking were the lifestyle behaviours that were found to have the strongest independent association with repeated DSH across the lifespan.
尽管人们越来越意识到有过反复故意自伤（DSH）史的患者身体疾病发病率高和生活方式不良，但针对可能对该人群造成问题的特定生活方式因素的研究甚少。本文旨在探讨在一组因自杀意念或 DSH 而到急诊科就诊的患者中，反复 DSH 与某些生活方式因素（包括均衡饮食、吃早餐、食用“垃圾”食品、体重、运动、物质/酒精使用、吸烟和社会支持）之间的关系。
2007 年至 2016 年，从参加 DSH 或自杀意念门诊的 448 名 ED 就诊者中收集生活方式和心理健康措施的数据。到达时测量生活方式行为（奇妙生活方式清单）和心理健康（抑郁、焦虑和压力量表）、临床诊断和既往 DSH 发作次数。检查生活方式变量与既往 DSH 发作次数之间的关系。
性别、年龄、抑郁症状、不良饮食和吸烟均与一生中 DSH 发作次数的平均值较高相关。其他不良生活方式行为呈非显著正趋势。DSH 发作次数与抑郁或焦虑障碍的诊断无关。在多元线性回归模型中，唯一具有统计学意义的因素是年龄、吸烟和均衡饮食，但吸烟与一生中 DSH 的关系受到更直接的 DSH 行为的调节。
在本研究中，对因急性心理健康问题而就诊于 ED 的患者进行服务转诊，发现均衡饮食和吸烟是与一生中反复 DSH 具有最强独立关联的生活方式行为。
