Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study.
Suicide attempts and nonsuicidal self-injury in the treatment of resistant depression in adolescents: findings from the TORDIA study.
复制标题
DOI：
10.1016/j.jaac.2011.04.003
复制
发表时间：
2011-08
影响因子：
13.3
通讯作者：
Brent DA
中科院分区：
文献类型：
--
作者：
Asarnow JR;Porta G;Spirito A;Emslie G;Clarke G;Wagner KD;Vitiello B;Keller M;Birmaher B;McCracken J;Mayes T;Berk M;Brent DA
探讨青少年难治性抑郁症患者自杀企图（SAs）和非自杀性自伤（NSSI）的临床及预后意义。通过充分的SSRI试验没有改善的抑郁青少年（N=334）被随机分配到有或没有认知行为治疗的药物转换组（SSRI或文拉法辛）。在基线和整个24周的治疗期间对自伤和不良反应进行评估。47.4%的青少年在基线时报告有自伤行为史：23.8%单独有自伤行为，14%自伤+ sa， 9.5%单独有sa行为。24周sa和自伤发生率分别为7%和11%；这些比率在基线时患有自伤+ sa的青少年中最高。自伤史可以预测第24周的sa事件（HR= 5.28, 95% CI: 1.80-15.47, z= 3.04, p= 0.002）和自伤事件（HR= 7.31, z= 4.19, 95% CI: 2.88-18.54, p< 0.001），并且比sa史（HR= 1.92, 95% CI: z= 2.29, p= 0.13）更能预测未来的sa企图。在预测sa事件发生时间的最简洁模型中，基线自伤史和绝望是显著的预测因子，调整了治疗效果。平行分析预测到第24周发生自伤的时间，确定基线自伤史和身体和/或性虐待史是重要的预测因素。自伤是难治性抑郁症青少年的常见问题，也是未来sa和自伤的重要预测因素，强调了针对预防自伤和自杀行为的策略的迫切需要。青少年抗ssri抑郁症的治疗（TORDIA）。URL: http://www.clinicaltrials.gov。唯一标识符：NCT00018902。
To evaluate the clinical and prognostic significance of suicide attempts (SAs) and non-suicidal self-injury (NSSI) in adolescents with treatment-resistant depression. Depressed adolescents who did not improve with an adequate SSRI trial (N=334) were randomized to a medication switch (SSRI or venlafaxine) with or without cognitive-behavior therapy. NSSI and SAs were assessed at baseline and throughout the 24-week treatment period. 47.4% of youths reported a history of self-injurious behavior at baseline: 23.8% NSS-alone, 14% NSSI+SAs, 9.5% SAs-alone. The 24-week incidence rates of SAs and NSSI were 7% and 11%, respectively; these rates were highest among youths with NSSI+SAs at baseline. NSSI history predicted both incident SAs (HR= 5.28, 95% CI: 1.80–15.47, z= 3.04, p=.002) and incident NSSI (HR= 7.31, z= 4.19, 95% CI: 2.88–18.54, p<.001) through week-24, and was a stronger predictor of future attempts than a history of SAs (HR= 1.92, 95% CI: z = 2.29, p=.13). In the most parsimonious model predicting to time to incident SAs, baseline NSSI history and hopelessness were significant predictors, adjusting for treatment effects. Parallel analyses predicting time to incident NSSI through week-24, identified baseline NSSI history and physical and/or sexual abuse history as significant predictors. NSSI is a common problem among youths with treatment resistant depression and a significant predictor of future SAs and NSSI, underscoring the critical need for strategies that target the prevention of both NSSI and suicidal behavior. Treatment of SSRI-Resistant Depression in Adolescents (TORDIA). URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00018902.
登录
查看更多内容
影响因子：
--
作者：
Brunner, Romuald;Parzer, Peter;Resch, Franz
通讯作者：
Resch, Franz
影响因子：
17.7
作者：
Posner, Kelly;Oquendo, Maria A.;Davies, Mark
通讯作者：
Davies, Mark
影响因子：
11.3
作者：
Nock, Matthew K.;Joiner, Thomas E., Jr.;Prinstein, Mitchell J.
通讯作者：
Prinstein, Mitchell J.
影响因子：
3.8
作者：
Cerutti, R.;Manca, M.;Gratz, Kim L.
通讯作者：
Gratz, Kim L.
DOI：
10.1097/chi.0b013e3181977476
发表时间：
2009-03-01
影响因子：
13.3
作者：
Asarnow, Joan Rosenbaum;Emslie, Graham;Brent, David
通讯作者：
Brent, David