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12 岁以下儿童再次尝试自杀的风险因素和特征。

Risk factors and profiles of reattempted suicide in children aged less than 12 years.

机构信息

Línea de Ayuda en Salud Mental (Línea Amiga 106), Centro Regulador de Urgencias y Emergencias de Boyacá, Tunja-Boyacá, Colombia; Programa de posgrado en Neuropsicología y Educación, Fundación Universitaria Internacional de La Rioja, Bogotá, Colombia.

Programa de posgrado en Neuropsicología y Educación, Fundación Universitaria Internacional de La Rioja, Bogotá, Colombia; Escuela de Enfermería, Universidad Pedagógica y Tecnológica de Colombia, UPTC, Tunja-Boyacá, Colombia.

出版信息

An Pediatr (Engl Ed). 2024 Nov;101(5):310-318. doi: 10.1016/j.anpede.2024.10.002. Epub 2024 Oct 25.

Abstract

OBJECTIVE

Suicide attempt (SA) repetition is considered one of the main risk factors for completed suicide. In spite of this, there is no previous research on this variable in children. The objective was to determine the factors and profiles associated with reattempted suicide in children aged less than 12 years.

METHODS

Cross-sectional study that included 120 reports (event code INS.356) of SA in children aged less than 12 years between 2018 and 2023 in the SIVIGILA surveillance system of Colombia. We carried out a bivariate logistic regression analysis to generate the best fitting risk factor model and a multiple correspondence analysis (MCA) to establish the possible SA recurrence profiles using the SPSS software, version 26.

RESULTS

Of the 120 cases analysed, 43 (35.8%) were reports of reattempted suicide. The best model for predicting risk factors for repeated SA included child maltreatment (OR, 6.22; P < .05), persistent suicidal ideation (PSI) (OR, 30.91; P < .001), a history of violence or sexual abuse (OR, 13.10; P < .05) and the use of sharp objects (OR, 46.45; P < .001). The MCA identified 3 profiles: "first SA" with poisoning as the attempt method and in absence of PSI, violence and abuse; "one previous SA" with the use of sharp objects and presence of PSI ; "two or more previous SAs" with a history of violence or sexual abuse, child maltreatment and hanging as the method.

CONCLUSION

Our findings demonstrate the impact of early life adversity (ELA) on children's mental health, so it is necessary to detect and prevent these types of abuse in order to reduce childhood suicide.

摘要

目的

自杀未遂(SA)的重复被认为是自杀完成的主要风险因素之一。尽管如此,此前针对儿童这一变量的研究并不多。本研究旨在确定与 12 岁以下儿童再次自杀企图相关的因素和特征。

方法

本研究为横断面研究,纳入了 2018 年至 2023 年哥伦比亚 SIVIGILA 监测系统中 120 例 12 岁以下儿童 SA(事件代码 INS.356)报告。我们进行了二元逻辑回归分析,以生成最佳拟合的风险因素模型,并使用 SPSS 软件(版本 26)进行多元对应分析(MCA),以确定可能的 SA 复发特征。

结果

在分析的 120 例病例中,43 例(35.8%)为重复自杀企图报告。预测重复 SA 的最佳风险因素模型包括儿童虐待(OR,6.22;P<.05)、持续自杀意念(PSI)(OR,30.91;P<.001)、暴力或性虐待史(OR,13.10;P<.05)和使用锐器(OR,46.45;P<.001)。MCA 确定了 3 个特征:“首次 SA”,尝试方法为中毒,无 PSI、暴力和虐待;“一次 SA 既往史”,使用锐器,存在 PSI;“两次或更多次 SA 既往史”,有暴力或性虐待史、儿童虐待和上吊作为方法。

结论

我们的研究结果表明,早期生活逆境(ELA)对儿童心理健康有影响,因此需要发现和预防这些类型的虐待,以降低儿童自杀率。

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