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处于精神病临床高危状态的年轻人的自杀性思维与行为:一项为期两年的随访研究中的精神病理学考量及治疗反应

Suicidal thinking and behavior in young people at Clinical High Risk for Psychosis: Psychopathological considerations and treatment response across a 2-year follow-up study.

作者信息

Pelizza Lorenzo, Di Lisi Alessandro, Leuci Emanuela, Quattrone Emanuela, Palmisano Derna, Pellegrini Clara, Pellegrini Pietro, Paulillo Giuseppina, Pupo Simona, Menchetti Marco

机构信息

Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum" Università Degli Studi di Bologna, Bologna, Italy.

Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Parma, Italy.

出版信息

Suicide Life Threat Behav. 2025 Feb;55(1):e13136. doi: 10.1111/sltb.13136. Epub 2024 Oct 19.

Abstract

INTRODUCTION

Suicidal ideation has high rates among individuals at Clinical High Risk for Psychosis (CHR-P). CHR-P mental states are currently defined as attenuated psychotic symptoms, brief intermittent psychotic symptoms, or genetic risk and functioning deterioration syndrome. However, the relationship between psychotic experiences and suicidality in CHR-P subjects is still not fully understood. Research emphasizes the need to address suicidality in CHR-P individuals due to its incidence and severe socio-economic impact. This study aimed to assess the baseline prevalence and 2-year incidence rates of suicidal thinking and behaviors in an Italian CHR-P sample, investigate the stability of suicidal ideation over 2 years, and examine its associations with treatment outcomes, sociodemographic characteristics, and clinical factors.

METHODS

CHR-P participants were treated in an "Early Intervention in Psychosis" program and completed the PANSS and the GAF scale at baseline and every 12 months.

RESULTS

180 CHR-P individuals were enrolled (92 with suicidal ideation [SI+]). SI+ subjects had a higher baseline prevalence of past suicide attempts. Over 2 years, a decrease in suicidal ideation severity was observed in the total group. Longitudinal improvement in disorganized symptoms was a key predictor of the decrease in suicidal ideation. Participants with a history of suicide attempts were more likely to attempt again.

CONCLUSION

Addressing disorganization is crucial for suicide prevention in the CHR-P population. Continuous risk monitoring and preventive actions are needed for those with past suicide attempts.

摘要

引言

在临床高危精神病个体(CHR-P)中,自杀意念发生率很高。CHR-P精神状态目前被定义为精神病性症状减弱、短暂间歇性精神病性症状或遗传风险与功能衰退综合征。然而,CHR-P个体中精神病性体验与自杀倾向之间的关系仍未完全明了。鉴于自杀意念的发生率及其严重的社会经济影响,研究强调应对CHR-P个体的自杀倾向。本研究旨在评估意大利CHR-P样本中自杀性思维和行为的基线患病率及2年发生率,调查自杀意念在2年期间的稳定性,并检验其与治疗结果、社会人口学特征及临床因素之间的关联。

方法

CHR-P参与者在“精神病早期干预”项目中接受治疗,并在基线时及每12个月完成阳性和阴性症状量表(PANSS)及大体功能评定量表(GAF)。

结果

共纳入180名CHR-P个体(92名有自杀意念[SI+])。SI+个体既往自杀未遂的基线患病率更高。在2年期间,观察到总体自杀意念严重程度有所下降。紊乱症状的纵向改善是自杀意念下降的关键预测因素。有自杀未遂史的参与者再次自杀未遂的可能性更大。

结论

解决紊乱症状对于CHR-P人群的自杀预防至关重要。对于有既往自杀未遂史的个体,需要持续进行风险监测和预防措施。

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