Predicting hospitalization versus discharge of suicidal patients presenting to a psychiatric emergency service
Predicting hospitalization versus discharge of suicidal patients presenting to a psychiatric emergency service
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DOI：
10.1176/appi.ps.58.4.561
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发表时间：
2007-04-01
影响因子：
3.8
通讯作者：
Bird, Suzanne
中科院分区：
文献类型：
--
作者：
Goldberg, Joseph F.;Ernst, Carrie L.;Bird, Suzanne
目的：自杀意念经常促使人们去精神科急诊室就诊，需要更多的信息来了解影响临床医生决定是否让有自杀意念的患者住院或出院的因素。方法：作者回顾了257例有自杀意念的精神科急诊患者的记录。住院的人口统计学和临床相关因素采用后向逐步二元logistic回归分析。结果如下：70%的自杀者住院治疗，并与精神病、自杀未遂史和自杀计划显著相关。在控制潜在混杂因素的情况下，这些变量正确分类了80%的住院决策。结论：精神病，过去的自杀企图，并存在一个自杀计划强烈预测的决定住院自杀的人看到精神科急诊服务。诊断，药物治疗，有一个精神科医生，和保险亚型无关的住院决定，这表明精神科急诊科工作人员认为很少有替代住院时，精神病和自杀计划伴随自杀意念。
Objective: Suicidal ideation frequently prompts visits to psychiatric emergency departments, and more information is needed about factors that mediate clinicians' decisions to hospitalize or discharge patients with suicidal ideation. Methods: The authors reviewed records for 257 patients presenting with suicidal ideation to a psychiatric emergency service. Demographic and clinical correlates of hospitalization were examined by backward stepwise binary logistic regression. Results: Hospitalization occurred for 70% of suicidal persons and was significantly associated with psychosis, a history of attempted suicide, and a suicidal plan. With potential confounding factors controlled, these variables correctly classified 80% of hospitalization decisions. Conclusions: Psychosis, past suicide attempts, and the presence of a suicide plan robustly predicted the decision to hospitalize suicidal persons seen in psychiatric emergency services. Diagnosis, pharmacotherapy, havng a psychiatrist, and insurance subtype were unrelated to hospitalization decisions, suggesting that psychiatric emergency department staff perceive few alternatives to hospitalization when psychosis and suicide plans accompany suicidal ideation.