Goldston D B, Kovacs M, Ho V Y, Parrone P L, Stiffler L
Department of Psychiatry and Behavioral Medicine, Bowman Gray School of Medicine of Wake Forest University.
J Am Acad Child Adolesc Psychiatry. 1994 Feb;33(2):240-6. doi: 10.1097/00004583-199402000-00013.
To investigate the prevalence and correlates of suicidal behaviors among youth with insulin-dependent diabetes mellitus (IDDM) for up to 12 years after disease onset.
The occurrence of suicidal ideation and suicide attempts was assessed shortly after disease onset and repeatedly thereafter as part of a longitudinal study of diabetic children. Initial psychiatric status and symptomatology, characteristics of the medical illness, and sociodemographic variables were considered as potential correlates of suicidal behaviors.
Young patients evidenced higher than expected rates of suicidal ideation, but relatively few attempted suicide over the follow-up. Among those who did attempt suicide, diabetes-related methods commonly were used. Suicidal ideation shortly after IDDM onset was related only to concurrent severity of depressive symptoms. Suicidal ideation over the follow-up was associated with later noncompliance with the medical regimen.
Clinicians should be alert to the possibility of suicidal ideation among youth with IDDM because of the prevalence of those cognitions, the potential lethality of attempts due to insulin misuse, and the relationship of suicidal thoughts to later noncompliance with the medical regimen.
调查胰岛素依赖型糖尿病（IDDM）青年患者发病后长达12年的自杀行为患病率及其相关因素。
作为糖尿病儿童纵向研究的一部分，在疾病发作后不久评估自杀意念和自杀未遂的发生情况，并在此后反复评估。初始精神状态和症状、疾病特征以及社会人口统计学变量被视为自杀行为的潜在相关因素。
年轻患者的自杀意念发生率高于预期，但在随访期间自杀未遂的相对较少。在那些确实自杀未遂的患者中，常用与糖尿病相关的方法。IDDM发病后不久的自杀意念仅与同时存在的抑郁症状严重程度有关。随访期间的自杀意念与后来不遵守医疗方案有关。
临床医生应警惕IDDM青年患者出现自杀意念的可能性，因为这些认知普遍存在，胰岛素滥用导致的自杀未遂具有潜在致死性，且自杀念头与后来不遵守医疗方案有关。
