Johnsson Fridell E, Ojehagen A, Träskman-Bendz L
Department of Psychiatry, Lund University Hospital, Sweden.
Acta Psychiatr Scand. 1996 Mar;93(3):151-7. doi: 10.1111/j.1600-0447.1996.tb10622.x.
Seventy-five patients were admitted to the ward of the Lund Suicide Research Center following a suicide attempt. After 5 years, the patients were followed up by a personal semistructured interview covering sociodemographic, psychosocial and psychiatric areas. Ten patients (13%) had committed suicide during the follow-up period, the majority within 2 years. They tended to be older at the index attempt admission, and most of them had a mood disorder in comparison with the others. Two patients had died from somatic diseases. Forty-two patients were interviewed, of whom 17 (40%) had reattempted during the follow-up period, most of them within 3 years. Predictors for reattempt were young age, personality disorder, parents having received treatment for psychiatric disorder, and a poor social network. At the index attempt, none of the reattempters had diagnoses of adjustment disorders or anxiety disorders. At follow-up, reattempters had more psychiatric symptoms (SCL-90), and their overall functioning (GAF) was poor compared to those who did not reattempt. All of the reattempters had long-lasting treatment ( > 3 years) as compared to 56% of the others. It is of great clinical importance to focus on treatment strategies for the vulnerable subgroup of self-destructive reattempters.
75名自杀未遂患者被收治于隆德自杀研究中心病房。5年后，通过涵盖社会人口学、心理社会及精神科领域的个人半结构化访谈对这些患者进行随访。10名患者（13%）在随访期间自杀，多数在2年内。他们在首次自杀未遂入院时年龄偏大，与其他患者相比，大多数患有心境障碍。2名患者死于躯体疾病。42名患者接受了访谈，其中17名（40%）在随访期间再次自杀未遂，多数在3年内。再次自杀未遂的预测因素包括年轻、人格障碍、父母曾接受精神科治疗以及社交网络不佳。在首次自杀未遂时，再次自杀未遂者均未诊断为适应障碍或焦虑障碍。随访时，再次自杀未遂者有更多精神症状（SCL - 90），与未再次自杀未遂者相比，其整体功能（GAF）较差。与56%的其他患者相比，所有再次自杀未遂者都接受了长期治疗（>3年）。关注有自我毁灭倾向的再次自杀未遂这一脆弱亚组的治疗策略具有重要的临床意义。
