Diagnostic comorbidity in persons with suicidal ideation and behavior.
Diagnostic comorbidity in persons with suicidal ideation and behavior.
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有自杀意念和行为的人的诊断合并症。
DOI：
10.1176/ajp.150.6.928
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Rajab,MH
中科院分区：
文献类型：
--
作者：
Rudd,MD;Dahm,PF;Rajab,MH
目的：在一个随机的社区样本中，符合惊恐障碍或惊恐发作诊断标准的个体有较高的自杀意念或行为风险，这一初步发现在后来对普通和特定精神科门诊患者群体的研究中没有得到重复。目前的研究是验证这一发现的又一次努力。方法选取209例有自杀未遂、持续自杀或最终自杀倾向的门诊患者。所有受试者都通过结构化的临床访谈进行评估，以分配DSM-III-R诊断、自杀意念修正量表、自杀概率量表的自杀意念子量表和贝克绝望量表。结果研究结果显示了自杀患者诊断共病的相对复杂性和重要性。情绪障碍是最常见的初级诊断，其次是恐惧症、创伤后应激障碍（PTSD）、广泛性焦虑症和恐慌症。惊恐障碍并不是一个孤立的、独立的诊断；相反，所有的恐慌症患者还至少接受了一项额外的合并症诊断。自杀意念和绝望的平均得分在当前合并原发性情绪障碍和恐慌障碍的患者中最高。然而，伴随的PTSD、广泛性焦虑障碍和恐惧症也起着至关重要的作用。结论：研究结果表明，在一个特定的临床群体中，惊恐障碍是自杀意念或行为的独立风险因素，这是另一个失败。然而，他们强调，当恐慌症和其他焦虑症与原发性情绪障碍同时发生时，它们可能是危险因素。
ObjectiveAn initial finding of heightened risk of suicidal ideation or behavior among individuals in a random community sample who met diagnostic criteria for panic disorder or panic attacks was not replicated in later studies of both general and specific groups of psychiatric outpatients. The present study represented another effort to validate the finding.MethodThe participants included 209 outpatients who had attempted suicide or were at high risk for continued suicidal behavior or eventual suicide. All subjects were evaluated with a structured clinical interview for assigning DSM-III-R diagnoses, the Modified Scale for Suicidal Ideation, the suicidal ideation subscale of the Suicide Probability Scale, and the Beck Hopelessness Scale.ResultsThe findings indicated the relative complexity and importance of diagnostic comorbidity among these suicidal subjects. Mood disorders were the most frequent primary diagnoses, followed by phobias, posttraumatic stress disorder (PTSD), generalized anxiety disorder, and panic disorder. Panic disorder was not present as an isolated, independent diagnosis; on the contrary, all of the patients with panic disorder also received at least one additional comorbid diagnosis. Mean scores for suicidal ideation and hopelessness were greatest for patients with current comorbid primary mood disorder and panic disorder. However, a critical and equally important role was played by comorbid PTSD, generalized anxiety disorder, and phobias.ConclusionsThe findings represent another failure to validate, with a specific clinical group, panic disorder as an independent risk factor for suicidal ideation or behavior. However, they highlight the possibility that panic disorder and other anxiety disorders are risk factors when they co-occur with a primary mood disorder.