Suicide and suicide attempts in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)
Suicide and suicide attempts in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)
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DOI：
10.1016/j.jad.2011.04.036
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发表时间：
2011-10-01
影响因子：
6.6
通讯作者：
Thase, Michael E.
中科院分区：
文献类型：
--
作者：
Dennehy, Ellen B.;Marangell, Lauren B.;Thase, Michael E.
背景：本报告描述了在参加双相情感障碍系统治疗强化计划 (STEP-BD) 研究时尝试或完成自杀的双相情感障碍患者。方法：描述了发生自杀事件的个体的基线和病程特征。结果：在纳入的 4360 名双相情感障碍患者中，有 182 人做出了 270 次前瞻性观察的自杀行为，其中 8 人完成了自杀。这代表 STEP-BD 中每 100 人年有 0.014 人自杀。其中包括频繁的临床就诊、循证护理以及每次接触患者时的标准化评估。大约 1/3 的自杀未遂者在参与研究期间曾尝试过不止一次。那些完成自杀的人往往在参与研究的早期就完成了，其中一半是在第一次尝试时完成的。 局限性：虽然本研究仅限于描述完成自杀和 STEP-BD 尝试的个人和促发者，但计划进一步分析以探索风险因素和预防双相情感障碍患者自杀行为的潜在干预措施。结论：双相情感障碍患者自杀的风险很高。 STEP-BD 中自杀事件的总体发生率低于预期，表明频繁的临床就诊（即获得护理）、标准化评估和循证治疗的结合对该人群有帮助。 (C) 2011 Elsevier B.V. 保留所有权利。
Background: The current report describes individuals with bipolar disorder who attempted or completed suicide while participating in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study.Methods: Baseline and course features of individuals with suicide events are described.Results: Among the 4360 people with bipolar disorder enrolled, 182 individuals made 270 prospectively observed suicidal acts, including 8 completed suicides. This represents a suicide rate of .014 per 100 person years in STEP-BD. which included frequent clinical visits, evidence based care, and standardized assessment at each patient contact. Approximately 1/3 of those who attempted suicide had more than one attempt during study participation. Those who completed suicide tended to do so early in study participation, and half of them did so on their first attempt.Limitations: While this study is limited to description of individuals and precipitants of completed suicides and attempts in STEP-BD, further analyses are planned to explore risk factors and potential interventions for prevention of suicidal acts in persons with bipolar disorder.Conclusions: Persons with bipolar disorder are at high risk for suicide. Overall rates of suicide events in STEP-BD were lower than expected, suggesting that the combination of frequent clinical visits (i.e.. access to care), standardized assessment, and evidence-based treatment were helpful in this population. (C) 2011 Elsevier B.V. All rights reserved.