青少年精神科人群随访 3 年后的自杀意念、功能及相关负性生活事件。
Suicidality, function and associated negative life events in an adolescent psychiatric population at 3-year follow-up.
机构信息
Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Children and Youth, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
出版信息
BMC Psychiatry. 2021 Feb 18;21(1):109. doi: 10.1186/s12888-021-03100-w.
BACKGROUND
We aimed to examine psychosocial function, suicidality and school dropout in a clinical psychiatric population over a 3-year period from adolescence to young adulthood and explore associations with negative life events.
METHODS
This study is part of the Health Survey in Department of Children and Youth, St. Olavs hospital, Norway. In the first study visit (T), 717 (43.5% of eligible) participated, aged 13-18 years (2009-2011), and 3 years later (T), 570 answered a questionnaire (school functioning and negative life events), and 549 completed Kiddie SADS as telephone interview assessing DSM-IV diagnoses, psychosocial functioning and suicidality.
RESULTS
Suicidal ideation was more frequent among girls (17.9%) than among boys (5.4%) (risk difference; RD = 12.5%, CI (7.2 to 17.7), p < 0.001), as was suicidal behavior (25.0% vs. 9.5%, RD = 15.5%, CI (9.2 to 21.4), p < 0.001). Girls had lower psychosocial functioning than boys (Children's Global Assessment Scale; Mean score 68.2 vs. 75.2, Mean difference = - 7.0, CI (- 9.4 to - 4.7), p < 0.001), and more school dropout (22.5% vs. 13.2%, RD = 9.3%, CI (2.8 to 15.5), p = 0.006). For those with a psychiatric disorder, 24.8% of girls had suicidal ideation and 30.0% suicidal behavior, which was larger than for boys (RD = 18.0%, CI (10.8 to 24.7), p < 0.001, and RD = 18.3%, CI (10.2 to 25.8), p < 0.001, respectively). Exposure to negative life events was frequent for both genders, but more girls had experienced sexually uncomfortable or abusive situations, the last 3 years (23.5% vs. 2.9%, RD = 20.6%, CI (15.4 to 25.7), p < 0.001), and ever (44.4% vs. 7.9%, RD = 36.5%, CI (29.9 to 42.7), p < 0.001). Suicidal behavior was associated with having been threatened, physically harassed or violently hurt (RD = 16.7%, CI (9.5 to 23.9), p < 0.001), and for girls been put into sexually uncomfortable or abusive situations (RD = 20.1%, CI (10.4 to 29.9), p < 0.001) and seen others violently hurt (RD = 14.6%, CI (3.4 to 25.8), p = 0.011).
CONCLUSIONS
The high frequency of suicidality and school dropout confirms the severity of adolescent psychiatric disorders, especially among girls. Specific life events were associated risk factors and should be target points for prevention and intervention.
背景
我们旨在研究从青少年到成年早期的 3 年期间，临床精神科人群的社会心理功能、自杀意念和辍学情况，并探讨与负面生活事件的关联。
方法
本研究是挪威圣奥拉夫医院儿童和青年部门健康调查的一部分。在第一次研究访问（T）中，717 人（符合条件的 43.5%）参加了研究，年龄为 13-18 岁（2009-2011 年），3 年后（T），570 人回答了一份问卷（学校功能和负面生活事件），549 人完成了 Kiddie SADS 作为电话访谈，评估 DSM-IV 诊断、社会心理功能和自杀意念。
结果
女孩中出现自杀意念的比例（17.9%）高于男孩（5.4%）（风险差异；RD=12.5%，CI（7.2 至 17.7），p<0.001），自杀行为也是如此（25.0%比 9.5%，RD=15.5%，CI（9.2 至 21.4），p<0.001）。女孩的社会心理功能比男孩差（儿童总体评估量表；平均得分 68.2 比 75.2，平均差异= -7.0，CI（-9.4 至 -4.7），p<0.001），辍学率更高（22.5%比 13.2%，RD=9.3%，CI（2.8 至 15.5），p=0.006）。对于那些患有精神障碍的人，24.8%的女孩有自杀意念，30.0%有自杀行为，这比男孩的比例更高（RD=18.0%，CI（10.8 至 24.7），p<0.001，和 RD=18.3%，CI（10.2 至 25.8），p<0.001，分别）。两种性别都经常经历负面生活事件，但更多的女孩在过去 3 年中经历过性不适或虐待的情况（23.5%比 2.9%，RD=20.6%，CI（15.4 至 25.7），p<0.001），并且曾经经历过（44.4%比 7.9%，RD=36.5%，CI（29.9 至 42.7），p<0.001）。自杀行为与受到威胁、身体骚扰或暴力伤害有关（RD=16.7%，CI（9.5 至 23.9），p<0.001），对于女孩来说，还与遭受性不适或虐待的情况有关（RD=20.1%，CI（10.4 至 29.9），p<0.001），以及目睹他人遭受暴力伤害有关（RD=14.6%，CI（3.4 至 25.8），p=0.011）。
结论
自杀意念和辍学的高频率证实了青少年精神障碍的严重性，尤其是女孩。特定的生活事件是相关的危险因素，应该成为预防和干预的目标。
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