Suicide risk in bipolar patients: the role of co-morbid substance use disorders
Suicide risk in bipolar patients: the role of co-morbid substance use disorders
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DOI：
10.1034/j.1399-5618.2003.00017.x
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发表时间：
2003-02-01
影响因子：
5.4
通讯作者：
Kennedy, JL
中科院分区：
文献类型：
--
作者：
Dalton, EJ;Cate-Carter, TD;Kennedy, JL
目的：双相情感障碍与自杀未遂和自杀未遂的高频率相关。本研究的主要目的是确定双相情感障碍患者自杀企图的临床预测因素。方法：我们研究了336名被诊断为双相I型、双相II型或分裂情感障碍（双相型）的受试者。进行了DSM-IV （SCID-I）的结构化临床访谈，随后两名专家精神病学家建立了诊断。对自杀未遂者和非自杀未遂者的自杀企图进行了预测。结果：整个样本的终生自杀未遂率为25.6%。终生共病性物质使用障碍是自杀企图的显著预测因子：双相情感障碍患者合并共病性物质使用障碍（SUD）的终生自杀未遂率为39.5%，而未合并的患者为23.8%（优势比=2.09,95% CI=1.03-4.21, chi(2)=4.33, df=1, p=0.037）。结论：双相情感障碍患者终生共病性SUD与较高的自杀企图率相关。这种关系可能有遗传起源和/或可以用疾病的严重程度和性格冲动来解释。
Objective: Bipolar disorder is associated with a high frequency of both completed suicides and suicide attempts. The primary aim of this study was to identify clinical predictors of suicide attempts in subjects with bipolar disorder.Methods: We studied 336 subjects with a diagnosis of bipolar I, bipolar II, or schizoaffective disorder (bipolar type). The Structured Clinical Interview for DSM-IV (SCID-I) was administered and subsequently two expert psychiatrists established a diagnosis. Predictors of suicide attempts were examined in attempters and non-attempters.Results: The lifetime rate of suicide attempts for the entire sample was 25.6%. A lifetime co-morbid substance use disorder was a significant predictor of suicide attempts: bipolar subjects with co-morbid substance use disorders (SUD) had a 39.5% lifetime rate of attempted suicide, while those without had a 23.8% rate (odds ratio=2.09, 95% CI=1.03-4.21, chi(2)=4.33, df=1, p=0.037).Conclusions: Lifetime co-morbid SUD were associated with a higher rate of suicide attempts in patients with bipolar disorder. This relationship may have a genetic origin and/or be explained by severity of illness and trait impulsivity.