Commentary: Self-harm in adolescents: the best predictor of death by suicide?--Reflections on Hawton et al. (2012).
Commentary: Self-harm in adolescents: the best predictor of death by suicide?--Reflections on Hawton et al. (2012).
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评论：青少年的自残：自杀死亡的最佳预测因素？——对霍顿等人的反思
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Dennis Ougrin
中科院分区：
文献类型：
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作者：
Dennis Ougrin
Hawton及其同事的前一篇文章报告了一项关于向事故和急诊部门（A&E）提出自我伤害的青少年的前瞻性研究，这是研究儿童和青少年自我伤害长期结果的最大流行病学研究之一。在平均6年后，近30%的人因自残而再次前往A&E，1%的人死亡，其中一半是由于可能的自杀，其余主要是由于事故。从死亡方式来看，可能很多意外死亡也是自杀。与有自残行为的成年人相比，自杀的绝对风险较低，尽管自残重复率很高。自伤切割是一个强大的独立预测自杀是以前的精神治疗和以前的自我伤害。最后，最终的自杀方法与第一次或最后一次自残时使用的方法不同。这与成人文学产生的数据不一致，这些数据一致表明，那些使用最暴力的自残方法的人，例如试图上吊或射击，往往也会使用这些方法死亡。
总之，青少年自我伤害的领域是非常重要的，需要迫切的研究，以发展我们的能力，预测那些可能死于自杀，并提供有效的治疗，以那些在风险。Hawton及其同事的这篇文章是我们理解那些存在自我伤害的青少年自杀风险因素的重要一步，并强调了自我伤害和自我中毒与自杀的重叠性质。
The preceding article by Hawton and colleagues reporting on a prospective study of adolescents presenting with self-harm to Accident and Emergency departments (A&E) is one of the largest epidemiological studies to examine the long-term outcomes of selfharm in children and adolescents. After a median of 6 years nearly 30% re-presented to A&E with self-harm and 1% died, half of those due to likely suicide and the rest mainly due to accidents. It may be that many accidental deaths were also suicides judging from the method of death. In comparison to adults presenting with self-harm, the absolute risk of suicide was lower despite a high self-harm repetition rate. Self-injury by cutting was a strong independent predictor of suicide as was previous psychiatric treatment and previous self-harm. Finally the eventual method of suicide was different from that used at either the first or the last episode of selfharm. This is at odds with the data generated by adult literature which consistently shows that those with the most violent methods of selfharm, e.g. attempted hanging or shooting, tend to also die using these methods.
In summary the field of adolescent self-harm is of immense importance and requires urgent research to develop our ability to predict those likely to die of suicide, and to offer effective treatment to those at risk. The article by Hawton and colleagues is an important step in our understanding of the risk factors of suicide in those adolescents who present with self-harm and in highlighting the overlapping nature of self-injury and self-poisoning in relation to suicide.