Goldston D B, Daniel S S, Reboussin B A, Reboussin D M, Kelley A E, Frazier P H
Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1087, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Sep;37(9):924-32. doi: 10.1097/00004583-199809000-00012.
To compare psychiatric diagnoses of hospitalized adolescents who (a) have made previous but no recent suicide attempts, (b) have recently made their first suicide attempt, (c) have recently made a second or subsequent attempt, or (d) have never made an attempt.
Semistructured psychiatric diagnostic interviews were used to determine psychiatric diagnoses and history of recent and previous suicidal behavior of 269 consecutively admitted adolescents to an inpatient psychiatric facility. Forty-nine previously suicidal youths, 28 first-time attempters, and 33 repeat attempters were compared with 159 nonsuicidal youths in prevalence of Axis I psychiatric disorders and psychiatric comorbidity with affective disorder.
Previous attempters and repeat attempters both reported more affective disorders, whereas first-time attempters reported more adjustment disorders than nonsuicidal youths. Previous attempters and nonsuicidal youths reported the most externalizing disorders.
Previous attempters on an inpatient unit have multiple psychiatric problems. Like repeat attempters, they often are depressed, but like nonsuicidal youths, they also exhibit significant externalizing behaviors. Interventions with these adolescents should focus not only on immediate presenting problems, but also on ameliorating their long-term risk of posthospitalization suicidal behavior.
比较住院青少年的精神科诊断情况，这些青少年分为以下几类：(a) 曾有过自杀未遂经历但近期无此类情况；(b) 近期首次尝试自杀；(c) 近期有过第二次或更多次自杀未遂；(d) 从未尝试过自杀。
采用半结构化精神科诊断访谈来确定269名连续入住一家住院精神科机构的青少年的精神科诊断以及近期和既往自杀行为史。将49名既往有自杀行为的青少年、28名首次尝试自杀者以及33名多次尝试自杀者与159名无自杀行为的青少年在轴I精神障碍患病率以及与情感障碍的精神科共病情况方面进行比较。
既往有自杀未遂经历者和多次尝试自杀者均报告有更多的情感障碍，而首次尝试自杀者报告的适应障碍比无自杀行为的青少年更多。既往有自杀未遂经历者和无自杀行为的青少年报告的外化障碍最多。
住院单元中的既往有自杀未遂经历者存在多种精神科问题。与多次尝试自杀者一样，他们常伴有抑郁，但与无自杀行为的青少年一样，他们也表现出显著的外化行为。对这些青少年的干预不仅应关注当前呈现的问题，还应致力于降低他们出院后自杀行为的长期风险。
