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首发精神病发病后两年内与自杀尝试相关的因素。

Factors associated with suicide attempts in first-episode psychosis during the first two years after onset.

机构信息

Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain; Fundació Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Spain.

Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain.

出版信息

Psychiatry Res. 2023 Jul;325:115232. doi: 10.1016/j.psychres.2023.115232. Epub 2023 Apr 28.

Abstract

The risk of suicide in first-episode psychosis (FEP) is high. However, there are many unknowns about this phenomenon and the risk factors associated with higher risk are not well-understood. Therefore, we aimed to determine the baseline sociodemographic and clinical factors associated with suicide attempts in FEP patients over two-years after psychosis onset. Univariate and logistic regression analyses were performed. Between April 2013 and July 2020, 279 patients treated at the FEP Intervention Program at our hospital (Hospital del Mar, Spain) were enrolled and 267 completed the follow-up. Of these, 30 patients (11.2%) made at least one suicide attempt, mostly during the untreated psychosis period (17 patients, 48.6%). Several variables-prior history of suicide attempts and low functionality, depression, and feelings of guilt at baseline-were all significantly associated with suicide attempts. These findings suggest that targeted interventions, especially in prodromal stages, could play a key role in identifying and treating FEP patients with a high suicide risk.

摘要

首发精神病(FEP)患者的自杀风险较高。然而,对于这一现象仍有许多未知,与更高风险相关的危险因素也尚未得到充分理解。因此,我们旨在确定精神病发作后两年内 FEP 患者自杀未遂的基线社会人口学和临床相关因素。进行了单变量和逻辑回归分析。2013 年 4 月至 2020 年 7 月,我们医院(西班牙巴塞罗那的玛尔医院)的首发精神病干预项目共招募了 279 名患者,其中 267 名完成了随访。其中,30 名患者(11.2%)至少有一次自杀未遂,大多数发生在未经治疗的精神病期(17 名患者,48.6%)。自杀未遂的基线时存在既往自杀史和低功能、抑郁和内疚感等几个变量与自杀未遂显著相关。这些发现表明,有针对性的干预措施,尤其是在前驱期,可能在识别和治疗具有高自杀风险的 FEP 患者方面发挥关键作用。

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