Brent D A, Perper J A, Moritz G, Allman C, Friend A, Roth C, Schweers J, Balach L, Baugher M
Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213.
J Am Acad Child Adolesc Psychiatry. 1993 May;32(3):521-9. doi: 10.1097/00004583-199305000-00006.
The objective of this study was to determine the psychiatric risk factors for adolescent suicide.
Sixty-seven adolescent suicide victims were compared with 67 demographically matched community controls. Psychiatric disorder was assessed in suicide victims using a psychological autopsy protocol and in controls using similar semistructured psychiatric interviews. Risk factors were quantified by use of the odds ratio (OR), that is, the relative frequency of the occurrence of a given condition in the suicides compared with the controls.
The most significant psychiatric risk factors associated with adolescent suicide were major depression (OR = 27.0), bipolar mixed state (OR = 9.0), substance abuse (OR = 8.5), and conduct disorder (OR = 6.0). Substance abuse was a more significant risk factor when comorbid with affective illness than when alone (OR = 17.0 versus 3.3). The majority of depressed suicide victims had a primary affective disorder (82%). A significant minority (31%) of depressed suicide victims had been depressed less than 3 months. Previous suicide attempts, suicidal ideation, and homicidal ideation also were associated with adolescent suicide.
The development of effective treatments for youth who fit the above-noted risk profiles should be given high priority.
本研究的目的是确定青少年自杀的精神风险因素。
将67名青少年自杀受害者与67名人口统计学特征匹配的社区对照者进行比较。采用心理解剖方案对自杀受害者进行精神障碍评估，对对照者采用类似的半结构化精神科访谈进行评估。通过比值比（OR）对风险因素进行量化，即与对照者相比，自杀者中特定状况发生的相对频率。
与青少年自杀相关的最显著精神风险因素为重度抑郁症（OR = 27.0）、双相混合状态（OR = 9.0）、物质滥用（OR = 8.5）和品行障碍（OR = 6.0）。物质滥用与情感性疾病共病时比单独存在时是更显著的风险因素（OR = 17.0对3.3）。大多数抑郁自杀受害者患有原发性情感障碍（82%）。少数抑郁自杀受害者（31%）抑郁时间不到3个月。既往自杀未遂、自杀意念和杀人意念也与青少年自杀有关。
应高度优先为符合上述风险特征的青少年开发有效的治疗方法。
