Beautrais A L, Joyce P R, Mulder R T
Canterbury Suicide Project, Christchurch School of Medicine, New Zealand.
J Am Acad Child Adolesc Psychiatry. 1998 May;37(5):504-11. doi: 10.1097/00004583-199805000-00013.
To compare the history of psychiatric contacts among young people who have made medically serious suicide attempts and control subjects.
Using a case-control design, the authors contrasted 129 young people who made serious suicide attempts with 153 randomly selected community controls on a series of measures of lifetime, prior year, and prior month contacts with psychiatric services.
Of those who made serious suicide attempts, 78.3% had a lifetime history of contact with health services for psychiatric reasons, 72.1% reported contact within the year preceding the suicide attempt 58.9% reported contact within the month preceding the suicide attempt, and 29.5% had a lifetime history of psychiatric hospital admission. Within the year preceding the suicide attempt, 21.7% had been admitted to a psychiatric hospital and 67.4% had outpatient consultations for psychiatric problems. Multiple logistic regression suggested that the best psychiatric service predictors of risk of serious suicide attempt were admission within the preceding year (p < .005) and outpatient consultation within the preceding month (p < .0001).
Young people making serious suicide attempts had vastly elevated rates of a range of psychiatric contacts including hospital admissions and outpatient consultations. These findings imply that the development of improved treatment and management strategies for young people with psychiatric morbidity may be a very effective approach to reducing youthful suicidal behaviors.
比较有严重自杀未遂医疗史的年轻人与对照对象的精神科就诊史。
采用病例对照设计,作者将129名有严重自杀未遂行为的年轻人与153名随机选取的社区对照对象在一系列终生、前一年及前一个月与精神科服务机构接触情况的指标上进行对比。
在有严重自杀未遂行为的人群中,78.3%有因精神问题而与医疗服务机构接触的终生史,72.1%报告在自杀未遂前一年有过接触,58.9%报告在自杀未遂前一个月有过接触,29.5%有精神科住院的终生史。在自杀未遂前一年,21.7%曾入住精神病院,67.4%因精神问题接受过门诊咨询。多元逻辑回归分析表明,严重自杀未遂风险的最佳精神科服务预测因素是前一年入院(p < 0.005)和前一个月门诊咨询(p < 0.0001)。
有严重自杀未遂行为的年轻人在包括住院和门诊咨询在内的一系列精神科接触方面的发生率大幅升高。这些发现表明,为有精神疾病的年轻人制定改进的治疗和管理策略可能是减少青少年自杀行为的一种非常有效的方法。