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青少年因自杀意念住院:生物标志物、社会和情感预测因素:一项队列研究。

Adolescents hospitalised for suicidality: biomarkers, social and affective predictors: a cohort study.

机构信息

Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA

Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA.

出版信息

BMJ Open. 2022 Oct 3;12(10):e056063. doi: 10.1136/bmjopen-2021-056063.

Abstract

OBJECTIVES

The present research examines genomics and in vivo dynamics of family context and experienced affect following discharge from psychiatric hospitalisation for suicidal thoughts and behaviours (STBs). The purpose of this paper is to provide an overview of a new model, description of model-guided integration of multiple methods, documentation of feasibility of recruitment and retention and a description of baseline sample characteristics.

DESIGN

The research involved a longitudinal, multimethod observational investigation.

SETTING

Participants were recruited from an inpatient child and adolescent psychiatric hospital. 194 participants ages 13-18 were recruited following hospitalisation for STB.

PRIMARY AND SECONDARY OUTCOME MEASURES

Participants underwent a battery of clinical interviews, self-report assessments and venipuncture. On discharge, participants were provided with a phone with (1) the electronically activated recorder (EAR), permitting acoustic capture later coded for social context, and (2) ecological momentary assessment, permitting assessment of in vivo experienced affect and STB. Participants agreed to follow-ups at 3 weeks and 6 months.

RESULTS

A total of 71.1% of approached patients consented to participation. Participants reported diversity in gender identity (11.6% reported transgender or other gender identity) and sexual orientation (47.6% reported heterosexual or straight sexual orientation). Clinical interviews supported a range of diagnoses with the largest proportion of participants meeting criteria for major depressive disorder (76.9%). History of trauma/maltreatment was prevalent. Enrolment rates and participant characteristics were similar to other observational studies.

CONCLUSIONS

The research protocol characterises in vivo, real-world experienced affect and observed family context as associated with STB in adolescents during the high-risk weeks post discharge, merging multiple fields of study.

摘要

目的

本研究考察了家庭环境和经历的影响在精神科住院治疗自杀意念和行为(STB)后的基因组学和体内动力学。本文的目的是提供一个新模型的概述,描述模型指导的多种方法的整合,记录招募和保留的可行性,并描述基线样本特征。

设计

这项研究涉及一项纵向、多方法观察性研究。

设置

参与者是从一家儿童和青少年精神病院的住院病人中招募的。194 名年龄在 13-18 岁的参与者在 STB 住院治疗后被招募。

主要和次要结果

参与者接受了一系列临床访谈、自我报告评估和静脉穿刺。出院时,参与者提供了一部带有(1)电子激活记录器(EAR)的手机,允许稍后对社交环境进行声学捕获,以及(2)生态瞬间评估,允许评估体内经历的情感和 STB。参与者同意在 3 周和 6 个月进行随访。

结果

共有 71.1%的被接触患者同意参与。参与者报告了性别认同的多样性(11.6%报告了跨性别或其他性别认同)和性取向(47.6%报告了异性恋或直性取向)。临床访谈支持一系列诊断,最大比例的参与者符合重度抑郁症的标准(76.9%)。创伤/虐待史很普遍。入组率和参与者特征与其他观察性研究相似。

结论

该研究方案描述了青少年在出院后高风险的几周内,体内经历的真实世界情感和观察到的家庭环境与 STB 的关系,融合了多个研究领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/9535190/2e3a7d111ec6/bmjopen-2021-056063f01.jpg

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