Brent D A, Kolko D J, Wartella M E, Boylan M B, Moritz G, Baugher M, Zelenak J P
Division of Child & Adolescent Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, PA 15213.
J Am Acad Child Adolesc Psychiatry. 1993 Jan;32(1):95-105. doi: 10.1097/00004583-199301000-00015.
Adolescent inpatients (of whom 48 were admitted for a suicide attempt, 33 were admitted for suicidal ideation, and 53 had no history of clinically significant suicidal ideation or attempt), were interviewed while in the hospital and then followed up 6 months later. Of the 134 patients followed up, 13 (9.7%) had made a suicide attempt. The vast majority of those who attempted suicide had been suicidal while in the hospital (12/13 or 92.3%). Other risk factors for suicidal behavior include major depression at intake, affective disorder with nonaffective comorbidity, a depressive disorder that continued through follow-up, death of a relative, and family financial problems. Suicidal inpatients, particularly those with chronic and recurrent affective illness, are at substantial risk for making a suicide attempt within 6 months of discharge. At follow-up, an even higher proportion showed attempts or suicidal ideation with a plan (N = 36 or 26.8%), with risk factors similar to those noted above. More intense outpatient or partial hospital interventions as a transition from the inpatient environment may be necessary to reduce the rate of recidivism among suicidal adolescents.
青少年住院患者(其中48人因自杀未遂入院,33人因自杀意念入院,53人无临床显著自杀意念或自杀未遂史)在住院期间接受了访谈,并在6个月后进行了随访。在接受随访的134名患者中,13人(9.7%)有自杀未遂行为。绝大多数自杀未遂者在住院期间就有自杀倾向(13人中的12人,即92.3%)。自杀行为的其他风险因素包括入院时的重度抑郁症、伴有非情感性共病的情感障碍、随访期间持续存在的抑郁症、亲属死亡以及家庭经济问题。有自杀行为的住院患者,尤其是那些患有慢性复发性情感疾病的患者,在出院后6个月内有很高的自杀未遂风险。在随访时,有更高比例的患者表现出自杀未遂或有计划的自杀意念(36人,占26.8%),风险因素与上述情况相似。作为从住院环境过渡的一种方式,可能需要更强化的门诊或部分住院干预措施,以降低自杀青少年的复发率。