Brent D A, Perper J A, Goldstein C E, Kolko D J, Allan M J, Allman C J, Zelenak J P
Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213.
Arch Gen Psychiatry. 1988 Jun;45(6):581-8. doi: 10.1001/archpsyc.1988.01800300079011.
The characteristics of adolescent suicide victims (n = 27) were compared with those of a group at high risk for suicide, suicidal psychiatric inpatients (n = 56) who had either seriously considered (n = 18) or actually attempted (n = 38) suicide. The suicide victims and suicidal inpatients showed similarly high rates of affective disorder and family histories of affective disorder, antisocial disorder, and suicide, suggesting that among adolescents there is a continuum of suicidality from ideation to completion. However, four putative risk factors were more prevalent among the suicide victims: (1) diagnosis of bipolar disorder; (2) affective disorder with comorbidity; (3) lack of previous mental health treatment; and (4) availability of firearms in the homes, which taken together accurately classified 81.9% of cases. In addition, suicide completers showed higher suicidal intent than did suicide attempters. These findings suggest a profile of psychiatric patients at high risk for suicide, and the proper identification and treatment of such patients may prevent suicide in high-risk clinical populations.
将27名青少年自杀受害者的特征与一组自杀高风险人群(56名有自杀行为的精神科住院患者,其中18人曾认真考虑过自杀,38人曾实际尝试过自杀)的特征进行比较。自杀受害者和有自杀行为的住院患者在情感障碍以及情感障碍、反社会障碍和自杀家族史方面呈现出相似的高发生率,这表明在青少年中,从自杀意念到自杀行为存在一个连续体。然而,有四个假定的风险因素在自杀受害者中更为普遍:(1)双相情感障碍诊断;(2)伴有共病的情感障碍;(3)既往未接受过心理健康治疗;(4)家中有枪支,这四个因素综合起来能准确分类81.9%的病例。此外,自杀成功者比自杀未遂者表现出更高的自杀意图。这些发现提示了自杀高风险精神科患者的特征,对这类患者的正确识别和治疗可能会预防高风险临床人群中的自杀行为。