Jones J S, Stein D J, Stanley B, Guido J R, Winchel R, Stanley M
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York.
Acta Psychiatr Scand. 1994 Feb;89(2):81-7. doi: 10.1111/j.1600-0447.1994.tb01491.x.
The aim of this study was to determine the value of positive, negative and depressive symptoms, and of the dexamethasone suppression test (DST), in differentiating schizophrenics with and without a history of suicide. Fifty-seven hospitalized patients with schizophrenia were assessed at the end of a neuroleptic free interval with the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scale for Depression (HRSD), and with a dexamethasone challenge. Suicide attempters were significantly more likely to meet criteria for major depression than nonattempters. Scores on the HRSD differentiated the two groups whereas the sums of positive and negative symptom items from the BPRS did not. DST a.m. and p.m. cortisol values differentiated suicide attempters from nonattempters and HRSD scores correlated significantly with cortisol levels. This study confirms the importance of depressive symptoms in schizophrenic patients with a history of suicide. Assessment of the hypothalamic-pituitary-adrenal axis in schizophrenia may also provide useful information.
本研究的目的是确定阳性、阴性和抑郁症状以及地塞米松抑制试验（DST）在区分有自杀史和无自杀史精神分裂症患者方面的价值。57例住院精神分裂症患者在停用抗精神病药物一段时间后，使用简明精神病评定量表（BPRS）、汉密尔顿抑郁评定量表（HRSD）进行评估，并接受地塞米松激发试验。有自杀未遂史的患者比无自杀未遂史的患者更有可能符合重度抑郁的标准。HRSD评分能够区分这两组患者，而BPRS中阳性和阴性症状项目的总和则不能。DST上午和下午的皮质醇值能够区分自杀未遂者和非自杀未遂者，且HRSD评分与皮质醇水平显著相关。本研究证实了抑郁症状在有自杀史的精神分裂症患者中的重要性。对精神分裂症患者下丘脑 - 垂体 - 肾上腺轴的评估也可能提供有用信息。
