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媒体报道应对自杀危机的故事对精神科患者的影响:随机对照试验。

Effects of media stories featuring coping with suicidal crises on psychiatric patients: Randomized controlled trial.

机构信息

Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.

Wiener Werkstaette for Suicide Research, Vienna, Austria.

出版信息

Eur Psychiatry. 2021 Nov 4;64(1):e70. doi: 10.1192/j.eurpsy.2021.2244.

Abstract

BACKGROUND

Accumulating evidence suggests beneficial effects of media stories featuring individuals mastering their suicidal crises, but effects have not been assessed for psychiatric patients.

METHODS

We randomized n = 172 adult psychiatric patients (n = 172, 97.1% inpatients) to read an educative article featuring a person mastering a suicidal crisis (n = 92) or an unrelated article (n = 80) in a single-blind randomized controlled trial. Questionnaire data were collected before (T1) and after exposure (T2) as well as 1 week later (study end-point, T3). The primary outcome was suicidal ideation as assessed with the Reasons for Living Inventory; secondary outcomes were help-seeking intentions, mood, hopelessness, and stigmatization. Differences between patients with affective versus other diagnoses were explored based on interaction tests.

RESULTS

We found that patients with affective disorders (n = 99) experienced a small-sized reduction of suicidal ideation at 1-week follow up (mean difference to control group [MD] at T3 = -0.17 [95% CI -0.33, -0.03], d = -0.15), whereas patients with nonaffective diagnoses (n = 73) experienced a small-sized increase (T2: MD = 0.24 [95% CI 0.06, 0.42], d = 0.19). Intervention group participants further experienced a nonsustained increase of help-seeking intentions (T2: MD = 0.53 [95% CI 0.11, 0.95], d = 0.19) and a nonsustained deterioration of mood (T2: MD = -0.14 [95% CI -0.27, -0.02], d = -0.17).

CONCLUSIONS

This study suggests that patients with affective disorders appear to benefit from media materials featuring mastery of suicidal crises. More research is needed to better understand which patient groups are at possible risk of unintended effects.

摘要

背景

越来越多的证据表明,媒体报道个人成功应对自杀危机的故事有积极影响,但尚未评估其对精神科患者的影响。

方法

我们将 172 名成年精神科患者(n=172,97.1%为住院患者)随机分为两组,分别阅读一篇介绍成功应对自杀危机的个人的教育文章(n=92)或一篇不相关的文章(n=80),采用单盲随机对照试验。在暴露前(T1)、暴露后(T2)以及 1 周后(研究终点,T3)收集问卷数据。主要结局指标为生活原因清单评估的自杀意念;次要结局指标为求助意愿、情绪、绝望和污名化。根据交互检验,探讨了有情感障碍与其他诊断的患者之间的差异。

结果

我们发现,有情感障碍的患者(n=99)在 1 周随访时自杀意念呈小幅度降低(T3 时与对照组的平均差异[MD]为-0.17[95%CI-0.33,-0.03],d=-0.15),而无情感障碍的患者(n=73)则呈小幅度增加(T2:MD=0.24[95%CI0.06,0.42],d=0.19)。干预组参与者进一步经历了求助意愿的短暂增加(T2:MD=0.53[95%CI0.11,0.95],d=0.19)和情绪的短暂恶化(T2:MD=-0.14[95%CI-0.27,-0.02],d=-0.17)。

结论

本研究表明,有情感障碍的患者似乎从媒体报道个人成功应对自杀危机的材料中受益。需要进一步研究以更好地了解哪些患者群体可能存在意外影响的风险。

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