Kishi Y, Robinson R G, Kosier J T
Department of Psychiatry, University of Iowa, Iowa City, USA.
Int Psychogeriatr. 1996 Winter;8(4):623-34. doi: 10.1017/s1041610296002931.
Three hundred one patients were examined for suicidal plans during the acute hospital period following stroke and at 3, 6, 12, and 24 months' follow-up. It was found that 6.6% of patients developed suicidal plans during the initial in-hospital evaluation (acute-onset suicidal plans) and 11.3% of patients developed suicidal plans at 3, 6, 12, or 24 months' follow-up (delayed-onset suicidal plans). The development of both acute and delayed-onset suicidal plans was strongly related to the existence of depressive disorders, especially major depression, and to a prior history of stroke. Acute-onset suicidal plans were also related to premorbid alcohol abuse. Acute-onset suicidal patients had more anterior lesion location and delayed-onset suicidal patients had more posterior stroke lesions. Delayed-onset suicidal plans were not related to alcohol abuse but tended to be associated with greater physical impairment and poorer social support during the acute poststroke period. These data suggest that the etiology of these two types of suicidal plans may be different with acute onset related to biological mechanisms and delayed onset related to psychological mechanisms.
在中风后的急性住院期间以及3、6、12和24个月的随访中，对301名患者进行了自杀计划检查。结果发现，6.6%的患者在初始住院评估期间制定了自杀计划（急性发作性自杀计划），11.3%的患者在3、6、12或24个月的随访中制定了自杀计划（迟发性自杀计划）。急性和迟发性自杀计划的形成都与抑郁症尤其是重度抑郁症的存在以及既往中风病史密切相关。急性发作性自杀计划还与病前酒精滥用有关。急性发作性自杀患者的病变部位更靠前，迟发性自杀患者的中风病变部位更靠后。迟发性自杀计划与酒精滥用无关，但在中风后的急性期往往与更严重的身体损伤和更差的社会支持有关。这些数据表明，这两种类型自杀计划的病因可能不同，急性发作与生物学机制有关，迟发性发作与心理机制有关。
