Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample
Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample
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DOI：
10.2147/ndt.s118304
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发表时间：
2016-01-01
影响因子：
3.2
通讯作者：
Mukaddes, Nahit Motavalli
中科院分区：
文献类型：
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作者：
Demirkaya, Sevcan Karakoc;Tutkunkardas, Mustafa Deniz;Mukaddes, Nahit Motavalli
目的：考虑到自杀是全世界青少年死亡最常见的原因之一，临床上对自闭症谱系障碍（ASD）儿童和青少年的自杀行为缺乏认识。本研究旨在评估高功能自闭症患者的自杀率（自杀意念、自杀行为和自杀企图）以及自杀的相关危险因素。方法：回顾了 55 名诊断为自闭症谱系障碍的青少年（6 名女孩，49 名男孩）的医疗记录，年龄在 7-20 岁之间。参与者都能够流利地说话，并且智力功能没有明显的限制。对参与者的临床评估是根据《精神障碍诊断和统计手册》第四版、学龄儿童情感障碍和精神分裂症文本修订标准和时间表（当前版和终生版）进行的。使用了埃斯金的自杀筛查问卷和社会人口统计数据表，包括自杀行为的详细历史。为了比较结果，研究组还分为自杀组和非自杀组。结果：自杀行为率为29%，自杀企图率为12.7%。自杀的类型有行为（43.7%）、想法（37.5%）和口头声明（18.7%）。一些离奇的行为被记录下来。情绪障碍、焦虑障碍和破坏性行为等精神障碍的共病率分别为23.6%、43.6%和65.4%。具有精神病特征、自杀行为阳性家族史和完成自杀的群体比非自杀群体表现出更高的自杀倾向。结论：与之前的研究结果一致，自闭症谱系障碍个体的自杀率更高。与典型发育个体相比，自杀行为的类型表现出一些差异。精神病特征的存在和阳性自杀家族史可能是自闭症儿童和青少年自杀的危险因素。为了预防自杀并实施保护性医疗保健系统，识别高危人群至关重要。
Objectives: Considering that suicide is one of the most common reasons of adolescent death worldwide, there is a lack of clinical awareness on suicidal behaviors of children and adolescents with autism spectrum disorder (ASD). The present study aims to assess the rate of suicidality (suicidal ideation, behaviors and attempts) and associated risk factors for suicidality in high functioning ASD.Methods: Medical records of 55 adolescents (six girls, 49 boys), aged between 7-20 years, with diagnosis of ASD were reviewed. The participants were all able to speak fluently and had no significant limitations in intellectual functioning. Clinical assessment of participants was carried out on the basis of Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision criteria and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Eskin's Suicide Screening Questionnaire and socio-demographic data form including detailed history of suicidal behaviors were used. The study group was also divided into suicidal and non-suicidal groups for the purpose of comparing the results.Results: The rate of suicidal behaviors was 29% and suicide attempt was 12.7%. Types of suicidality were behaviors (43.7%), thoughts (37.5%), and verbal declarations (18.7%). A number of bizarre acts were recorded. Rates of comorbid psychiatric disorders such as mood disorders, anxiety disorders and disruptive behaviors were 23.6%, 43.6% and 65.4% respectively. Groups with the psychotic features, positive family history for suicidal behaviors and completed suicide showed more suicidality than the non-suicidal group.Conclusion: Consistent with the previous findings, rate of suicidality is higher in individuals with ASD. The type of suicidal behaviors showed some differences compared to typically developing individuals. The presence of psychotic features and positive family history for suicidality may be risk factors for suicidality in children and adolescents with ASD. To prevent suicide and implement protective health care systems, identifying the population at risk is crucial.