Weilemann L S, Hilgers H J, Reckmann A
Klinische Toxikologie, Johannes-Gutenberg-Universität Mainz.
Med Klin (Munich). 1996 Jun 15;91(6):355-8.
The study was designed to evaluate critically the background, findings and outcome in patients who have carried out suicidal and parasuicidal acts.
All parasuicidal patients who were admitted to the Department of Medicine of the University of Mainz over a period of 1 year were investigated. The basic data of all patients was documented (time of the parasuicidal act, stay in hospital, clinical parameters, psychiatric appraisals and therapy instituted). The semistructured interview "European Parasuicide Study Interview Schedule (EPSIS)" of the WHO/EURO was used to record the psychosocial background.
The 153 patients were mostly suffering from intoxications with sedatives and psychoactive agents: they comprised 53 male (35%) and 100 female (65%) patients. The average age was 36 years. Eighty-two suicide patients were treated in the emergency admission section and 65 in intensive-care units. The duration of treatment in the emergency admission section averaged 9 hours, as compared to about 6 days on the intensive-care unit. Extracentral effects were most prominent amongst the "sequelae" of intoxications. Discharged directly to their homes were 58%, 31% to psychiatric hospitals and 9% to general wards; 2% died. The primary elimination of poison was achieved by induced vomiting in 40% of the cases, and by pumping out the stomach in 23%. There were no serious clinical alterations of clinical test parameters. Artificial ventilation was required in 8%. 107 suicide cases (61%) investigated psychiatrically showed moderate (41%) and severe (20%) psychological abnormalities. Depressive syndrome (35%, of these 1 third with major depression), which frequently occurred in the context of an acute stress reaction, predominated amongst the diagnoses. Forty-two patients could be interviewed 6 days after suicide or parasuicide. Of those 90% interviewed had visited their family doctor in the course of the year before the current admission. Thirty-one patients had already received outpatient therapy and 15 had undergone an inpatient form of psychiatric therapy.
本研究旨在严格评估实施自杀及准自杀行为患者的背景、调查结果及结局。
对美因茨大学医学部一年内收治的所有准自杀患者进行调查。记录所有患者的基础数据（准自杀行为发生时间、住院时间、临床参数、精神评估及所采取的治疗措施）。采用世界卫生组织/欧洲区域办事处的半结构化访谈“欧洲准自杀研究访谈日程表（EPSIS）”记录社会心理背景。
153例患者大多为镇静剂和精神活性药物中毒：其中男性53例（35%），女性100例（65%）。平均年龄为36岁。82例自杀患者在急诊入院区接受治疗，65例在重症监护病房接受治疗。急诊入院区的平均治疗时间为9小时，而重症监护病房约为6天。中毒“后遗症”中，中枢外效应最为突出。58%的患者直接出院回家，31%转入精神病医院，9%转入普通病房；2%死亡。40%的病例通过催吐实现毒物初步清除，23%通过洗胃清除。临床检验参数无严重临床改变。8%的患者需要人工通气。经精神科调查的107例自杀病例（61%）显示存在中度（41%）和重度（20%）心理异常。抑郁综合征（占35%，其中三分之一为重度抑郁）在诊断中占主导地位，常发生于急性应激反应背景下。42例患者在自杀或准自杀6天后接受访谈。其中90%的受访者在本次入院前一年中曾就诊于家庭医生。31例患者已接受门诊治疗，15例接受过住院形式的精神科治疗。
