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青少年精神科住院患者的自杀意念和行为。

Suicidal Thoughts and Behaviors Among Adolescent Psychiatric Inpatients.

出版信息

Arch Suicide Res. 2023 Apr-Jun;27(2):353-366. doi: 10.1080/13811118.2021.1999874. Epub 2021 Nov 11.

Abstract

BACKGROUND

Given low base rates of suicidal thoughts and behaviors (STBs) in national samples of adolescents, clarifying the sociodemographic and clinical correlates among psychiatric inpatients may afford insights into potential risk factors that predict STBs onset.

METHOD

Adolescents ( = 970; ages 12-19 years) admitted for acute, psychiatric inpatient care completed baseline clinical interviews and self-report measures assessing demographics and early life adversity. Lifetime and 12-month STBs prevalence were obtained, allowing for the estimate of STBs persistence (i.e., rates of those with both current and past STBs) and transition rates (i.e., proportion of ideators that transition to plans or attempts). Univariate and multivariate logistic regression tested sociodemographic and clinical correlates of STBs.

RESULTS

Age-of-onset for STBs occurred in early adolescence. Most patients reported suicide ideation with nearly half of patients making a plan and one-third a suicide attempt. Although relatively modest, the strongest correlates of lifetime attempts were depressive disorders, physical abuse, and non-suicidal self-injury. Knowing a peer that had attempted suicide also increased the likelihood of a suicide attempt, especially among attempters who transitioned from ideation to planned attempts.

CONCLUSION

STBs are highly prevalent among adolescents admitted for acute psychiatric inpatient treatment. The modest effects suggest that correlates, particularly those related to suicide attempts, are widely distributed. As a history of physical abuse and knowing a peer with a suicide attempt history are related to transitioning from ideation to action, these may be critical factors to target in the deployment of future suicide prevention and treatment programs. HIGHLIGHTSOne-third of adolescent inpatients report a lifetime history of suicide attempts.Approximately 65% of adolescent inpatients with a lifetime plan attempt suicide.Knowing peers who attempt suicide may facilitate the transition from ideation to action.

摘要

背景

由于自杀念头和行为(STB)在全国青少年样本中的基础率较低,因此明确精神科住院患者的社会人口统计学和临床相关性可能有助于深入了解预测 STB 发病的潜在风险因素。

方法

接受急性、精神科住院治疗的青少年( = 970;年龄 12-19 岁)完成了基线临床访谈和自我报告的评估,这些评估包括人口统计学和早期生活逆境。获得了终生和 12 个月 STB 的患病率,从而可以估计 STB 的持续性(即既有当前 STB 又有过去 STB 的患者比例)和转变率(即有自杀意念的患者转变为计划或尝试的比例)。单变量和多变量逻辑回归检验了 STB 的社会人口统计学和临床相关性。

结果

STB 的发病年龄出现在青少年早期。大多数患者报告有自杀意念,近一半的患者有自杀计划,三分之一的患者有自杀企图。尽管相对较小,但终生尝试的最强相关因素是抑郁障碍、身体虐待和非自杀性自我伤害。认识有自杀企图的同龄人也增加了自杀企图的可能性,尤其是那些从自杀意念到计划尝试的自杀企图者。

结论

急性精神科住院治疗的青少年中 STB 非常普遍。适度的影响表明,相关性,特别是与自杀企图有关的相关性,广泛分布。由于身体虐待史和认识有自杀史的同龄人与从意念到行动的转变有关,这些可能是未来自杀预防和治疗计划部署的关键因素。

要点

  • 三分之一的青少年住院患者报告有自杀企图的终生史。

  • 大约 65%有自杀计划的青少年住院患者会尝试自杀。

  • 了解尝试自杀的同龄人可能会促进从意念到行动的转变。

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