Risk factors for suicide in bipolar I disorder in two prospectively studied cohorts.
Risk factors for suicide in bipolar I disorder in two prospectively studied cohorts.
复制标题
两个前瞻性研究队列中 I 型双相情感障碍自杀的危险因素。
DOI：
10.1016/j.jad.2015.10.007
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发表时间：
2016
影响因子：
6.6
通讯作者：
Fiedorowicz,Jess
中科院分区：
文献类型：
--
作者：
Coryell,William;Kriener,Abby;Butcher,Brandon;Nurnberger,John;McMahon,Francis;Berrettini,Wade;Fiedorowicz,Jess
这些分析是为了确定在两个前瞻性研究的双相I型患者队列中是否出现类似的自杀风险因素。方法NIMH抑郁症合作研究（CDS）在1978-1981年间招募了288名寻求治疗的双相I型患者。研究对象每半年随访一次，然后每年随访一次，随访时间长达30年。双相基因组学研究通过临床转诊和广告确定个体。没有进行临床随访，但1748人的个人标识符与国家死亡指数（NDI）记录相匹配。Kaplan-Meier生存分析测试了10个潜在的危险因素。结果CDS随访和基因组随访分别为12667人和4529人年。自杀率/100人年分别为0.26和0.055。预测自杀的人口学或临床变量在两个队列中差异很大。有任何自杀企图史的人自杀的比值比分别为2.3和2.8，是两项研究中测试的风险因素中第三高的比值比。在其中一个队列中，与NDI相匹配是确定死亡和死因的唯一手段。在两个队列中的一个中，抑郁症状评分在大多数情况下适用于过去重度抑郁发作的患者。结论：自杀风险研究中参与者来源的差异可能导致自杀率和风险因素在研究中存在显著差异。在所有样本中，自杀企图史是一个相对强大的风险因素。
BackgroundThese analyses were undertaken to determine whether similar risk factors for suicide emerged across two prospectively studied cohorts of individuals with bipolar I disorder.MethodsThe NIMH Collaborative Study of Depression (CDS) recruited 288 patients with bipolar I disorder from 1978–1981 as they sought treatment. Subjects were followed semiannually and then annually for up to 30 years. The Bipolar Genomics studies identified individuals through clinical referrals and advertisement. Clinical follow-up did not occur but personal identifiers of 1748 were matched with National Death Index (NDI) records. Kaplan–Meier survival analyses tested ten potential risk factors.ResultsThe CDS and Genomic follow-ups encompassed 12,667 and 4529 person-years, respectively. Suicides/100 person-years were 0.26 and 0.055. The demographic or clinical variables that predicted suicide differed considerably in the two cohorts. The odds ratio for suicide for those with any history of suicide attempt was 2.3 and 2.8, respectively, and was the third highest odds ratio of the tested risk factors in both studies.Limitations1.In one of the two cohorts, matching to the NDI was the only means available to ascertain death and cause of death.2.In one of the two cohorts, depressive symptom ratings were, in most cases, applied to those of a past major depressive episode.ConclusionsDifferences in the sources of participants in studies of suicide risk may result in marked differences across studies in both rates of suicide and in risk factors. A history of suicide attempt is a relatively robust risk factor across samples.