Clinical correlates of inpatient suicide
Clinical correlates of inpatient suicide
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DOI：
10.4088/jcp.v64n0105
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发表时间：
2003-01-01
影响因子：
5.3
通讯作者：
Jacobs, DG
中科院分区：
文献类型：
--
作者：
Busch, KA;Fawcett, J;Jacobs, DG
背景：以前的自杀评估研究已经导致了标准的风险预测。尽管如此，美国每年约有3万人自杀，其中5%至6%发生在医院。本研究的主要目的是提高我们的能力，评估风险和干预successful.Method：图表从76例自杀，而在医院，或出院后立即进行了审查。自杀前一周被评为两个标准的风险预测因子，并使用项目的时间表情感障碍和精神分裂症（SADS），存在和严重程度的症状，发现与急性risk in recent studies.Results：关于标准的预测因子，只有49%（N = 37）有任何先前的自杀企图和25%（N = 19）被接纳为这个原因。39%（30/76）因自杀意念入院，但78%在最后一次沟通时否认自杀意念; 46%（N = 35）未显示精神病证据;在采取预防措施的患者（N = 45）中，51%（N = 23）接受了q15分钟自杀检查或1：1观察; 28%（N = 21）的人签订了有效的无自杀合同。在SADS评级，79%（N = 60）符合标准的严重或极端焦虑和/或agitation.Conclusion：标准的风险评估和标准的预防措施是有限的价值，在保护这组自杀。在我们目前的评估中增加焦虑和激动的严重程度可能有助于识别处于急性风险的患者，并建议有效的治疗干预措施。一个匹配的对照组的重要性是明确的，以确定这个样本是否可以从没有自杀的住院病人中盲目区分出来。
Background: Previous suicide assessment research has led to standard predictors of risk. Despite this, there are approximately 30,000 suicides per year in the United States, 5% to 6% of which occur in hospitals. The primary purpose of this study is to improve our ability to assess risk and intervene successfully.Method: Charts from 76 patients who committed suicide while in the hospital, or immediately after discharge, were reviewed. The week before suicide was rated for both standard risk predictors and, using items from the Schedule for Affective Disorders and Schizophrenia (SADS), for presence and severity of symptoms found to be correlated with acute risk in recent studies.Results: Regarding standard predictors, only 49% (N = 37) had any prior suicide attempt and 25% (N = 19) were admitted for this reason. Thirty-nine percent (30/76) were admitted for suicidal ideation, but 78% denied suicidal ideation at their last communication about this; 46% (N = 35) showed no evidence of psychosis; of those on precautions (N = 45), 51% (N = 23) were on q 15 minute suicide checks or 1:1 observation; and 28% (N = 21) had a no-suicide contract in effect. On SADS ratings, 79% (N = 60) met criteria for severe or extreme anxiety and/or agitation.Conclusion: Standard risk assessments and standard precautions used were of limited value in protecting this group from suicide. Adding severity of anxiety and agitation to our current assessments may help identify patients at acute risk and suggest effective treatment interventions. The importance of a matched comparison group to ascertain if this sample can be blindly discriminated from inpatients who do not commit suicide is clear.