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基于ADAPTE方法制定精神科患者自杀预防临床指南

Development of a Clinical Guideline for Suicide Prevention in Psychiatric Patients Based on the ADAPTE Methodology.

作者信息

Yang Jeong Hun, Yoo Jieun, Kang Dae Hun, Park C Hyung Keun, Rhee Sang Jin, Kim Min Ji, Lee Sang Yeol, Shim Se-Hoon, Moon Jung-Joon, Cho Seong-Jin, Kim Shin Gyeom, Kim Min-Hyuk, Lee Jinhee, Kang Won Sub, Lee Weon-Young, Ahn Yong Min

机构信息

Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Republic of Korea.

Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Psychiatry Investig. 2024 Oct;21(10):1149-1166. doi: 10.30773/pi.2024.0195. Epub 2024 Sep 30.

Abstract

OBJECTIVE

Suicide is a significant public health issue, with South Korea having the highest suicide rate among Organisation for Economic Cooperation and Development countries. This study aimed to develop clinical guidelines for suicide prevention in psychiatric patients in Korea using the ADAPTE methodology.

METHODS

The development process involved a comprehensive review of literature, expert consultations, and consensus-building using the Nominal Group Technique and Delphi method. The guidelines focus on evidence-based psychiatric treatments, including both pharmacological and non-pharmacological approaches, tailored to the Korean context. Key findings underscoring the need for standardized treatment protocols for patients with major psychiatric disorders, including bipolar disorder, major depressive disorder, and schizophrenia.

RESULTS

The guidelines incorporate treatments like lithium, clozapine, atypical antipsychotics, electroconvulsive therapy, and cognitive behavioral therapy, which have shown effectiveness in suicide prevention. Applicability and acceptability within Korea's healthcare system were addressed, ensuring feasibility given the country's medical insurance coverage and accessibility. The guidelines were validated through expert reviews and Delphi rounds, achieving consensus on the final recommendations.

CONCLUSION

The developed guidelines provide a structured, evidence-based approach to reducing suicide rates among psychiatric patients in Korea. Future research will focus on expanding these guidelines to include screening protocols for high-risk groups.

摘要

目的

自杀是一个重大的公共卫生问题,韩国在经济合作与发展组织国家中自杀率最高。本研究旨在运用ADAPTE方法制定韩国精神病患者自杀预防临床指南。

方法

制定过程包括对文献进行全面综述、专家咨询,并采用名义群体技术和德尔菲法达成共识。这些指南侧重于基于证据的精神病治疗方法,包括药物治疗和非药物治疗方法,并针对韩国的情况进行了调整。关键研究结果强调了为双相情感障碍、重度抑郁症和精神分裂症等重度精神疾病患者制定标准化治疗方案的必要性。

结果

这些指南纳入了锂盐、氯氮平、非典型抗精神病药物、电休克治疗和认知行为治疗等已证明在预防自杀方面有效的治疗方法。讨论了在韩国医疗保健系统中的适用性和可接受性,鉴于该国的医疗保险覆盖范围和可及性,确保了指南的可行性。通过专家评审和德尔菲轮次对指南进行了验证,就最终建议达成了共识。

结论

制定的指南为降低韩国精神病患者的自杀率提供了一种结构化的、基于证据的方法。未来的研究将集中于扩展这些指南,以纳入针对高危群体的筛查方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fca/11513862/ce088fc2fff0/pi-2024-0195f1.jpg

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