Goldston D B, Daniel S, Reboussin D M, Kelley A, Ievers C, Brunstetter R
Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC 27157-1087, USA.
J Am Acad Child Adolesc Psychiatry. 1996 May;35(5):631-9. doi: 10.1097/00004583-199605000-00018.
To compare clinical characteristics of hospitalized adolescents who (1) have recently made their first suicide attempt, (2) have recently made a second or subsequent attempt, (3) have made previous but no recent attempts, or (4) have never made an attempt.
Semistructured psychiatric diagnostic interviews were used to determine history of recent and previous suicidal behavior among 225 consecutively admitted adolescents to an inpatient psychiatric facility. Twenty-seven first-time attempters, 32 repeat attempters, and 40 previously suicidal youths were compared with 126 nonsuicidal youths in terms of severity of self-reported depressive symptoms, state anxiety, trait anxiety, state anger, and trait anger.
Repeat attempters and previous attempters both reported more depressive symptomatology and trait anxiety than did nonsuicidal youths. In addition, youths with a previous history of suicide attempts, but no recent attempts, evidenced more trait anger than all other groups. First-time suicide attempters reported levels of distress that were intermediate to the other groups.
Repeat attempters and previous attempters in hospital settings both report more distress than do nonsuicidal youths. Interventions should focus not only on resolution of immediate crises, but also on youths' ability to cope with ongoing difficulties that engender depression and chronic anxiety.
比较住院青少年的临床特征，这些青少年分为以下四类：（1）最近首次尝试自杀；（2）最近进行了第二次或后续自杀尝试；（3）以前有过自杀尝试但近期没有；（4）从未尝试过自杀。
采用半结构化精神病学诊断访谈来确定225名连续入住一家住院精神病治疗机构的青少年近期和既往的自杀行为史。将27名首次自杀未遂者、32名多次自杀未遂者和40名既往有自杀行为的青少年与126名无自杀行为的青少年在自我报告的抑郁症状、状态焦虑、特质焦虑、状态愤怒和特质愤怒的严重程度方面进行比较。
多次自杀未遂者和既往有自杀未遂史者报告的抑郁症状和特质焦虑均多于无自杀行为的青少年。此外，有既往自杀未遂史但近期未尝试自杀的青少年表现出比其他所有组更多的特质愤怒。首次自杀未遂者报告的痛苦程度介于其他组之间。
在医院环境中，多次自杀未遂者和既往有自杀未遂史者报告的痛苦均多于无自杀行为的青少年。干预措施不仅应侧重于解决眼前的危机，还应关注青少年应对导致抑郁和慢性焦虑的持续困难的能力。
