Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy.
Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Italy; Department of Mental Health, Rome 2 Local Health Unit, Italy.
J Affect Disord. 2024 Dec 15;367:408-415. doi: 10.1016/j.jad.2024.08.223. Epub 2024 Sep 1.
Studies in the literature mainly focus on understanding the risk factors for suicide, giving little relevance to protective variables. This study aimed at exploring the specific contribution of protective variables (resilience, coping and psychological well-being) in hospitalized suicide attempt (SA) makers.
We recruited 50 inpatients who made a SA before admission and 50 inpatients with no history of SA matched for DSM-5 diagnosis, gender and age. Protective variables were evaluated with: Brief COPE questionnaire, Dispositional Resilience Scale (DRS-15), Psychological Well-Being Scale (PWB-18). Psychopathological features and symptom severity were assessed with: Global Assessment of Functioning Scale (GAF), Rapid Dimensional Assessment Scale (SVARAD), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions (CGI), Hamilton Depression Rating Scale (HDRS17).
The DRS-15 total score was significantly lower in SA makers. SA makers displayed significantly lower scores on the Engagement and Cognitive Restructuring subscales of the Brief COPE. On the PWB-18, the Self-Acceptance subscale score was lower in SA makers.
The small sample size suggests the need for caution in interpreting the results. Matching was carried out by excluding diagnoses of personality disorders.
Patients hospitalized following a SA are more often diagnosed with personality disorders, have deficit areas concerning resilience and coping, and lower psychological well-being compared to patients without a SA. When approaching a patient who has committed a SA, it may be useful to evaluate protective variables as well as risk factors, and encourage the development of adaptive coping mechanisms and positive self-evaluation through more dynamic therapeutic paths.
文献中的研究主要侧重于理解自杀的风险因素，而很少关注保护变量。本研究旨在探讨保护变量（韧性、应对和心理幸福感）在住院自杀未遂（SA）者中的具体作用。
我们招募了 50 名在入院前有过 SA 的住院患者和 50 名符合 DSM-5 诊断、性别和年龄匹配的无 SA 史的住院患者。使用以下量表评估保护变量：简要应对方式问卷、特质韧性量表（DRS-15）、心理幸福感量表（PWB-18）。使用以下量表评估精神病理特征和症状严重程度：功能总体评估量表（GAF）、快速维度评估量表（SVARAD）、简明精神病评定量表（BPRS）、临床总体印象量表（CGI）、汉密尔顿抑郁量表（HDRS17）。
SA 者的 DRS-15 总分显著较低。SA 者在简要应对方式问卷的投入和认知重构分量表上的得分明显较低。在 PWB-18 中，SA 者的自我接纳分量表得分较低。
样本量小提示在解释结果时需谨慎。通过排除人格障碍的诊断进行匹配。
与无 SA 史的患者相比，住院 SA 患者更常被诊断为人格障碍，在韧性和应对方面存在缺陷，心理幸福感较低。在接触有 SA 史的患者时，评估保护变量以及风险因素可能会很有用，并通过更具活力的治疗路径鼓励发展适应性应对机制和积极的自我评价。
