Elliott A J, Pages K P, Russo J, Wilson L G, Roy-Byrne P P
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA.
J Clin Psychiatry. 1996 Dec;57(12):567-71. doi: 10.4088/jcp.v57n1202.
This study identified factors associated with medically serious suicide attempts (requiring medical hospitalization).
Demographic information, current psychiatric mental state, suicide attempt and psychiatric history characteristics, and DSM-IV diagnoses were compared between 65 patients hospitalized for a medically serious suicide attempt (MSSA) and 32 patients seen in the emergency room for suicide attempt but not medically hospitalized (NMSSA).
Those with MSSAs had a higher rate of substance-induced mood disorder (but not substance abuse or dependence), while those with NMSSA had more attempts, more years since first attempt, and a higher rate of sexual and physical abuse, traumatic life events, borderline personality disorder, and bipolar disorder.
Substance-induced mood disorder is an important diagnosis in the evaluation of suicidal patients. The vulnerability of mood effects caused by substance abuse may lead to a more serious suicide attempt despite less extensive psychiatric problems. The most important early psychiatric intervention may be the immediate recognition and aggressive treatment of an individual's affective and substance use disorders.
本研究确定了与需要住院治疗的严重自杀未遂相关的因素。
比较了65例因严重自杀未遂(MSSA)住院的患者和32例在急诊室就诊但未住院治疗的自杀未遂患者(NMSSA)的人口统计学信息、当前精神状态、自杀未遂及精神病史特征,以及DSM-IV诊断。
严重自杀未遂患者中物质所致心境障碍的发生率较高(但不存在物质滥用或依赖),而未住院治疗的自杀未遂患者自杀未遂次数更多、首次自杀未遂后时间更长,且性虐待和身体虐待、创伤性生活事件、边缘型人格障碍及双相情感障碍的发生率更高。
物质所致心境障碍是评估自杀患者时的一项重要诊断。尽管精神问题不那么广泛,但物质滥用导致的心境影响易感性可能导致更严重的自杀未遂。最重要的早期精神科干预可能是立即识别并积极治疗个体的情感障碍和物质使用障碍。