A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R)
A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R)
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DOI：
10.1017/s0033291706008786
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发表时间：
2006-12-01
影响因子：
6.9
通讯作者：
Kessler, Ronald C.
中科院分区：
文献类型：
--
作者：
Borges, Guilherme;Angst, Jules;Kessler, Ronald C.
背景。关于自杀企图可能性的临床判断将会得到一个危险因素指数的帮助，这个指数可以在不同的情况下快速评估。我们试图为自杀意念者在12个月内的自杀企图制定这样的风险指数。全国共病调查复制（NCS-R）是一项针对18岁以上成年人的家庭调查，评估了5692名受访者在12个月内发生自杀意念、计划和企图的情况。回顾性评估的相关因素包括既往自杀史、社会人口统计学、父母精神病理和12个月的DSM-IV障碍。12个月自杀意念、计划和企图的流行率估计为2。6 0()。7和0（。）分别为4%。尽管有计划的人比没有计划的人更有可能尝试（31.9%），但有计划的人比没有计划的人（9.9%）更有可能尝试。6%)， 43%的企图被描述为计划外的。历史或之前的尝试与12个月的尝试最相关。其他重要的相关因素包括较短的构思时间，自杀计划的存在，以及一些社会人口统计学和父母精神病理学变量。12个月的精神障碍并没有很强的相关性。相关者的四类汇总指数与参与者之间的尝试密切相关[接受者操作者特征曲线下面积(AUC)=0(.)88]。风险指数的分布（尝试条件概率）为：19（。）0%极低(0)0%), 51()。1%低(3)5%), 16%（。）2%中间体（21）3%), 13%（%）。7%高（78）。1%)。三分之二(67)。1%)的尝试是由高危类别的思想者做出的。一个简短的、初步的风险指数是基于对完全结构化问题的回顾性报告的回答，该指数与12个月内意念者的自杀企图密切相关，高风险意念者的自杀企图高度集中。
Background. Clinical judgments about the likelihood of suicide attempt Would be aided by an index of risk Factors that could be quickly assessed in diverse settings. We Sought to develop such a risk index for 12-month suicide attempts among suicide ideators.Method. The National Comorbidity Survey Replication (NCS-R), a household survey of adults aged 18 +, assessed the 12-month occurrence Of Suicide ideation, plans and attempts in a subsample of 5692 respondents. Retrospectively assessed correlates include history of prior suicidality, socio-demographics, parental psychopathology and 12-month DSM-IV disorders.Results. Twelve-month prevalence estimates of suicide ideation, plans and attempts are 2(.)6, 0(.)7 and 0(.)4 % respectively. Although ideators with a plan are more likely to make an attempt (31(.)9%,,) than those without a plan (9(.)6%), 43% of attempts were described as unplanned. History or prior attempts is the strongest correlate of 12-month attempts. Other significant correlates include shorter duration of ideation, presence of a suicide plan, and several socio-demographic and parental psychopathology variables. Twelve-month disorders are not powerful correlates. A four-category summary index of correlates is strongly related to attempts among ideators [area under the receiver operator characteristic curve (AUC)=0(.)88]. The distribution (conditional probability of attempt) of the risk index is: 19(.)0% very low (0(.)0%), 51(.)1% low (3(.)5 %), 16(.)2 % intermediate (21(.)3 %), and 13(.)7% high (78(.)1 %). Two-thirds (67(.)1 %) of attempts were made by ideators in the high-risk category.Conclusions. A short, preliminary risk index based on retrospectively reported responses to fully structured questions is strongly correlated with 12-month suicide attempts among ideators, with a high concentration or attempts among high-risk ideators.