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多方法评估强迫症和相关障碍治疗患者的自杀意念和行为。

Multi-method assessment of suicidal thoughts and behaviors among patients in treatment for OCD and related disorders.

机构信息

Obsessive Compulsive Disorder Institute, McLean Hospital, United States; Department of Psychiatry, Harvard Medical School, United States.

Obsessive Compulsive Disorder Institute, McLean Hospital, United States.

出版信息

Psychiatry Res. 2024 Mar;333:115740. doi: 10.1016/j.psychres.2024.115740. Epub 2024 Jan 14.

Abstract

Obsessive-compulsive and related disorders (OCRDs) are associated with increased risk of suicidal thoughts and behaviors (STBs), yet research characterizing suicidality in OCRDs remains limited. A major challenge in assessing STBs is the reliance on explicit self-report. This study utilized multi-method assessment to examine changes in both implicit and explicit STBs in 31 adults receiving partial/residential treatment for OCRDs. Assessments were administered at admission and weekly during treatment. Approximately three-quarters of participants reported lifetime suicidal thoughts, with 16 % reporting a prior suicide attempt. OCD severity was significantly correlated with lifetime suicidal thoughts, and was significantly higher for those with lifetime suicidal thoughts and prior attempts compared to those without. Implicit biases towards death were not associated with OCD severity, and did not predict explicitly endorsed STBs. This is the first study to measure both explicit and implicit STBs in adults with OCRDs. Limitations included small sample size and lack of racial/ethnic diversity. Given the majority had recent suicidal thoughts and one in six had a prior attempt, we emphasize the importance of STB assessment in OCD treatment settings.

摘要

强迫及相关障碍(OCRD)与自杀意念和行为(STB)的风险增加有关,但描述 OCRD 中自杀行为的研究仍然有限。评估 STB 的一个主要挑战是依赖明确的自我报告。本研究利用多方法评估,在接受 OCRD 部分/住院治疗的 31 名成年人中,检查了内隐和外显 STB 的变化。评估在入院时和治疗期间每周进行一次。大约四分之三的参与者报告有过自杀念头,其中 16%的人曾有过自杀企图。强迫症严重程度与自杀念头有显著相关性,且与有自杀念头和自杀企图的参与者相比,无自杀念头和自杀企图的参与者的严重程度更高。对死亡的内隐偏见与强迫症严重程度无关,也不能预测明确的自杀意念。这是第一项在 OCRD 成人中同时测量外显和内隐 STB 的研究。研究的局限性包括样本量小和缺乏种族/民族多样性。鉴于大多数人最近有自杀念头,六分之一的人有过自杀企图,因此我们强调在强迫症治疗环境中进行 STB 评估的重要性。

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