A study on the association of psychiatric diagnoses and childhood adversities with suicide risk
A study on the association of psychiatric diagnoses and childhood adversities with suicide risk
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DOI：
10.1080/08039488.2018.1493748
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发表时间：
2019-02-17
影响因子：
1.8
通讯作者：
Hietala, Jarmo
中科院分区：
文献类型：
--
作者：
Salokangas, Raimo K. R.;Luutonen, Sinikka;Hietala, Jarmo
背景：除了精神疾病外，童年逆境也可能增加自杀行为的风险。在以前的研究中，临床共病和儿童期逆境重叠的影响很少被考虑在内。目的：本研究旨在探讨精神病诊断和儿童期逆境和创伤（CAT）与自杀风险的关系。研究方法：共有415名参加初级和精神科门诊治疗的成年患者填写了创伤和痛苦量表，包括对五个核心CAT领域（情感，身体和性虐待，情感和身体忽视）的评估。研究患者目前的精神疾病和自杀风险进行了评估的迷你国际神经精神访谈。结果如下：年龄，健康状况差，社会支持差，目前的精神病治疗，所有的精神疾病，除了轻躁狂，情感和身体虐待，情感忽视与自杀风险显着相关。精神疾病和CAT域的数量对自杀风险有剂量依赖性影响。在多变量分析中，目前的精神病治疗，当前和终身的抑郁症，社交恐惧症，酒精，药物依赖，以及情绪虐待与自杀风险有直接关系。在女性中，躁狂症和药物依赖，以及在男性中，心境恶劣，社交恐惧症和情感虐待与自杀风险相关。结论：精神疾病和大多数CAT领域与自杀风险相关。然而，当CAT域的共病和重叠的影响得到控制时，重度抑郁症，社交恐惧症，酒精，药物依赖和情感虐待似乎会增加自杀的风险。风险状况因性别而异。
Background: In addition to psychiatric disorders, childhood adversities may increase the risk of suicidal behavior. In previous studies, the effects of clinical co-morbidity and overlap of childhood adversities has rarely been taken into account. Aim: The study aims to search associations of psychiatric diagnoses and childhood adversities and trauma (CAT) with suicide risk. Methods: Altogether 415 adult patients attending primary and psychiatric outpatient care filled in the Trauma and Distress Scale, including assessment of five core CAT domains (emotional, physical and sexual abuse, and emotional and physical neglect). The study patients' current psychiatric disorders and suicide risk were assessed by the Mini International Neuropsychiatric Interview. Results: Age, poor perceived health, poor social support, current psychiatric treatment, all psychiatric disorders, except hypomania, emotional and physical abuse, and emotional neglect did associate significantly with suicide risk. Number of psychiatric disorders and CAT domains had dose-dependent effects on suicide risk. In multivariate analysis, current psychiatric treatment, current and life-time major depression, social phobia, alcohol, and drug dependency, as well as emotional abuse had direct associations with suicide risk. In females, manic disorders and drug dependence, and in males, dysthymia, social phobia, and emotional abuse associated with suicide risk. Conclusions: Psychiatric disorders and most CAT domains associate with suicide risk. However, when the effect of co-morbidity and overlap of CAT domains is controlled, major depression, social phobia, alcohol, and drug dependency and emotional abuse seem to increase the risk of suicide. The risk profile varies between the genders.