Saito Maiko, Shiratori Yuki, Yaguchi Chie, Yamada Noriko, Ogawa Takafumi, Karashima Masahide, Mizuhiki Takashi, Hori Takafumi, Tachikawa Hirokazu
Ibaraki Prefectural Medical Center of Psychiatry Kasama Japan.
Master Program in Medical Sciences, Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan.
PCN Rep. 2025 Aug 3;4(3):e70173. doi: 10.1002/pcn5.70173. eCollection 2025 Sep.
Preventing suicide reattempts is important; however, few evidence-based treatments are available. In Japan, the ACTION-J study helped implement case management for suicide attempters in general hospitals and reduced suicide reattempts over a period of up to 6 months. Therefore, the current study aimed to evaluate the effectiveness of case management, modeled after the ACTION-J study, when applied in psychiatric hospitals, and examined the factors influencing suicide reattempts to propose more effective methods of support.
We conducted a 1-year follow-up study on suicide reattempts after discharge among participants who received case management interventions. Baseline characteristics were extracted, and Cox regression analysis was used to identify the factors influencing suicide reattempts.
Of the 205 participants, 47 (22.9%) reattempted suicide during the observation period. Univariate analysis revealed that the factors significantly associated with suicide reattempts included younger age, adjustment disorder, dissociative disorder, history of previous suicide attempts, and the use of drug overdose as the method of the current attempt. Multivariate analysis showed that dissociative disorders were significant independent factors for suicide attempts.
Factors influencing suicide reattempts among participants in the case management intervention included younger age, adjustment disorder, dissociative disorder, history of previous suicide attempts, and overdose as the method of attempt. In addition to a history of previous suicide attempts and overdoses, which were previously reported, dissociative disorder was observed to strongly influence suicide reattempts, even after case management. Therefore, additional psychotherapeutic strategies, particularly for individuals with dissociative disorders or frequent suicide attempts, may be necessary.
预防自杀未遂的再次发生至关重要；然而，几乎没有基于证据的治疗方法。在日本，“行动-J”研究有助于在综合医院对自杀未遂者实施个案管理，并在长达6个月的时间内减少了自杀未遂的再次发生。因此，本研究旨在评估模仿“行动-J”研究在精神病医院应用时个案管理的有效性，并研究影响自杀未遂再次发生的因素，以提出更有效的支持方法。
我们对接受个案管理干预的参与者出院后自杀未遂情况进行了为期1年的随访研究。提取基线特征，并使用Cox回归分析来确定影响自杀未遂再次发生的因素。
在205名参与者中，47名（22.9%）在观察期内再次尝试自杀。单因素分析显示，与自杀未遂再次发生显著相关的因素包括年龄较小、适应障碍、分离性障碍、既往自杀未遂史以及本次尝试使用药物过量作为方法。多因素分析表明，分离性障碍是自杀未遂的显著独立因素。
个案管理干预参与者中影响自杀未遂再次发生的因素包括年龄较小、适应障碍、分离性障碍、既往自杀未遂史以及使用过量药物作为尝试方法。除了既往报道的自杀未遂史和药物过量外，分离性障碍即使在个案管理后也被观察到对自杀未遂再次发生有强烈影响。因此，可能需要额外的心理治疗策略，特别是针对患有分离性障碍或频繁自杀未遂的个体。
