Pfeffer C R, Klerman G L, Hurt S W, Kakuma T, Peskin J R, Siefker C A
Cornell University Medical College, NY.
J Am Acad Child Adolesc Psychiatry. 1993 Jan;32(1):106-13. doi: 10.1097/00004583-199301000-00016.
Rates and psychosocial risk factors for suicide attempts during a 6 to 8-year follow-up period were compared for 25 predominantly prepubertal inpatient suicide attempters, 28 inpatient suicidal ideators, 16 nonsuicidal inpatients, and 64 nonpatients.
Standard research instruments were used to interview subjects and parents. Cox proportional hazard regression analyses were used to identify risk factors for a suicide attempt in the follow-up.
No deaths occurred during follow-up. Suicide attempters were six times and suicidal ideators were three times more likely than were nonpatients to attempt suicide during follow-up. Poor social adjustment and mood disorder close to a recurrent suicide attempt were the strongest risk factors.
Risk assessment should focus on identifying symptoms of mood disorders and impaired social adjustment in children with histories of suicide attempts and psychiatric hospitalization.
对25名主要为青春期前的住院自杀未遂者、28名住院自杀意念者、16名非自杀住院患者和64名非患者在6至8年的随访期内自杀未遂的发生率及心理社会风险因素进行比较。
使用标准研究工具对受试者及其父母进行访谈。采用Cox比例风险回归分析来确定随访中自杀未遂的风险因素。
随访期间无死亡发生。自杀未遂者在随访期间自杀未遂的可能性是非患者的6倍,有自杀意念者是3倍。社会适应不良和接近复发性自杀未遂的情绪障碍是最强的风险因素。
风险评估应侧重于识别有自杀未遂史和精神科住院史儿童的情绪障碍症状和社会适应受损情况。