Ivarsson T, Larsson B, Gillberg C
Department of Child & Adolescent Psychiatry, Göteborg University, Sweden.
Eur Child Adolesc Psychiatry. 1998 Jun;7(2):96-104. doi: 10.1007/s007870050053.
One hundred eleven (58%) of 191 adolescent inpatients previously admitted to the emergency wards at the Child and Adolescent Psychiatric Clinics in the cities of Uppsala and Göteborg participated in a 2-4 year follow-up evaluation. The prevalence, incidence, and stability of depressive symptoms, suicidal ideation, and suicide attempts among the adolescents, and predictors of follow-up functioning were examined. Although a majority of the patients substantially reduced their depressive symptoms over the 2-4 year period, a smaller group (13%), mainly girls (94%), continued reporting high symptom levels at follow-up, and one out of five adolescents had moderate-severe levels of suicidal ideation. The accumulated frequency of suicide attempts among the patients shortly prior to hospitalization and during the follow-up was 59% including two patients who committed suicide. Significant predictors of depressive symptom severity at follow-up were depressive symptom scores and V-diagnoses at inpatient assessment. Previous suicide attempts before hospitalization, high levels of self-reported depressive symptoms and nonintact family status at inpatient assessment predicted suicide attempts during the follow-up period. The high prevalence of attempted and completed suicide in this clinical group underscores the importance of developing effective treatments for suicidal adolescents.
乌普萨拉市和哥德堡市儿童与青少年精神科诊所急诊病房之前收治的191名青少年住院患者中，111名（58%）参与了为期2至4年的随访评估。研究人员考察了青少年中抑郁症状、自杀意念和自杀未遂的患病率、发病率及稳定性，以及随访功能的预测因素。尽管大多数患者在2至4年期间抑郁症状大幅减轻，但仍有一小部分患者（13%），主要是女孩（94%），在随访时持续报告高症状水平，并且五分之一的青少年有中度至重度自杀意念。患者在住院前不久及随访期间自杀未遂的累计发生率为59%，其中包括两名自杀身亡的患者。随访时抑郁症状严重程度的显著预测因素是住院评估时的抑郁症状评分和V诊断。住院前曾有自杀未遂、自我报告的抑郁症状水平高以及住院评估时家庭状况不完整，可预测随访期间的自杀未遂。该临床组中自杀未遂和自杀身亡的高发生率凸显了为有自杀倾向的青少年开发有效治疗方法的重要性。
