Asnis G M, Friedman T A, Sanderson W C, Kaplan M L, van Praag H M, Harkavy-Friedman J M
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467-2490.
Am J Psychiatry. 1993 Jan;150(1):108-12. doi: 10.1176/ajp.150.1.108.
Because the findings of previous studies of suicidal behaviors in psychiatric outpatients may not necessarily generalize to outpatients with a wide spectrum of psychiatric diagnoses, the authors evaluated the prevalence of suicidal behaviors in a large general psychiatric outpatient clinic whose patients represented a full spectrum of psychiatric illness.
A total of 651 patients participated in the study between 1987 and 1989. These patients had sought treatment at the outpatient psychiatry department of a private nonprofit hospital. Before being interviewed for treatment, all patients were given a comprehensive self-rating survey packet that included the Harkavy Asnis Suicide Survey and the Hopkins Symptom Checklist-90. The Harkavy Asnis Suicide Survey is a self-report questionnaire that assesses demographic variables, current and past history of suicidal behaviors of the patient as well as family members and peers, and a detailed description of each previous attempt.
Fifty-five percent of the patients had a history of suicidal ideation, and 25% reported at least one previous suicide attempt. Approximately half of the suicide attempters reported multiple attempts. The predominant methods of attempt were overdose (53%), jumping (17%), and wrist cutting (17%). Suicidal behavior was prevalent in most diagnostic groups. The rates of suicidal ideation among patients with mood disorders (major depression, dysthymia, and bipolar disorder), adjustment disorders, and alcohol/substance abuse were significantly greater than that of the patients with generalized anxiety disorder.
The authors conclude that suicidal behavior is prevalent among patients who seek treatment in a general outpatient department.
由于先前针对精神科门诊患者自杀行为的研究结果未必能推广至患有广泛精神科诊断的门诊患者，作者评估了一家大型综合精神科门诊诊所中自杀行为的患病率，该诊所的患者涵盖了全谱系的精神疾病。
1987年至1989年间共有651名患者参与了该研究。这些患者在一家私立非营利性医院的门诊精神科寻求治疗。在接受治疗访谈前，所有患者都收到了一份综合自评调查问卷包，其中包括哈卡维·阿斯尼斯自杀调查问卷和霍普金斯症状清单-90。哈卡维·阿斯尼斯自杀调查问卷是一份自我报告问卷，用于评估人口统计学变量、患者以及家庭成员和同伴当前及过去的自杀行为史，以及对之前每次自杀未遂的详细描述。
55%的患者有自杀意念史，25%的患者报告至少有过一次自杀未遂。约一半的自杀未遂者报告有多次未遂经历。主要的自杀未遂方式是过量服药（53%）、跳楼（17%）和割腕（17%）。自杀行为在大多数诊断组中都很普遍。情绪障碍（重度抑郁症、心境恶劣和双相情感障碍）、适应障碍以及酒精/物质滥用患者的自杀意念发生率显著高于广泛性焦虑障碍患者。
作者得出结论，自杀行为在综合门诊部寻求治疗的患者中很普遍。
