Hintikka J, Viinamäki H, Koivumaa-Honkanen H T, Saarinen P, Tanskanen A, Lehtonen J
Department of Psychiatry, Kuopio University Hospital, Finland.
Soc Psychiatry Psychiatr Epidemiol. 1998 May;33(5):235-40. doi: 10.1007/s001270050049.
Sociodemographic and clinical risk factors for suicidal ideation have been less studied than risk factors for parasuicide and suicide. No reports on associations between therapy satisfaction and suicidal ideation among psychiatric patients have been published. In this study we compared a group of patients with suicidal ideation (n = 84) with a randomly selected group of nonsuicidal patients (n = 166) in community-based psychiatric services. Patients with suicidal ideation felt a need for psychiatric treatment more often than nonsuicidal patients. They were also more likely to receive antidepressive medication, and weekly therapy sessions were more common among them. A wish to change therapist (OR 15.6, 95% CI 3.6-67.8), hopeless future orientation (OR 14.8, 95% CI 4.5-48.9), severe depression as evaluated by the Beck Depression Inventory (OR 14.0, 95% CI 4.3-45.2) and dysthymia (OR 12.8, 95% CI 1.7-97.3) were the factors most strongly associated with suicidal ideation in multivariate analysis. A wish to change therapist is an expression of therapy dissatisfaction, which may therefore be among the factors most strongly associated with suicidal ideation in psychiatric patients. To help prevent suicidality among psychiatric patients special attention to therapy factors is needed.
与自杀未遂和自杀的风险因素相比，对自杀意念的社会人口统计学和临床风险因素的研究较少。目前尚未发表关于精神科患者治疗满意度与自杀意念之间关联的报告。在本研究中，我们将一组有自杀意念的患者（n = 84）与社区精神科服务中随机选取的一组无自杀意念的患者（n = 166）进行了比较。有自杀意念的患者比无自杀意念的患者更常感到需要接受精神科治疗。他们也更有可能接受抗抑郁药物治疗，并且每周治疗 sessions 在他们中更常见。在多变量分析中，希望更换治疗师（比值比15.6，95%可信区间3.6 - 67.8）、对未来感到绝望（比值比14.8，95%可信区间4.5 - 48.9）、根据贝克抑郁量表评估的重度抑郁（比值比14.0，95%可信区间4.3 - 45.2）和心境恶劣（比值比12.8，95%可信区间1.7 - 97.3）是与自杀意念最密切相关的因素。希望更换治疗师是治疗不满的一种表现，因此可能是精神科患者中与自杀意念最密切相关的因素之一。为帮助预防精神科患者的自杀行为，需要特别关注治疗因素。
原文中“weekly therapy sessions”里的“sessions”未明确具体意思，这里保留英文未翻译。
