Sex differences in clinical predictors of suicidal acts after major depression: A prospective study
Sex differences in clinical predictors of suicidal acts after major depression: A prospective study
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DOI：
10.1176/appi.ajp.164.1.134
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发表时间：
2007-01-01
影响因子：
17.7
通讯作者：
Mann, J. John
中科院分区：
文献类型：
--
作者：
Oquendo, Maria A.;Bongiovi-Garcia, Mary E.;Mann, J. John
目的：自杀行为相关的临床危险因素是否存在性别差异尚不清楚。作者假设，在重度抑郁发作的男性中，攻击性、敌意和物质滥用史增加了未来自杀行为的风险，而抑郁症状、童年虐待史、生活理由减少和边缘型人格障碍在抑郁女性中也是如此。方法：DSM-III-R重性抑郁症或双相情感障碍患者寻求治疗重性抑郁发作（N=314）进行了为期2年的随访。结果：在随访期间，16.6%的患者企图或自杀。自杀行为的家族史，过去的药物使用，吸烟，边缘型人格障碍，以及父母早期分离，每一个都增加了男性未来自杀行为的风险三倍以上。对于女性来说，未来自杀行为的风险是先前自杀者的六倍;过去的每一次尝试都会使未来的风险增加三倍。自杀意念，致命的过去的企图，敌意，主观抑郁症状，生活的原因少，共病的边缘型人格障碍，吸烟也增加了未来的自杀行为的风险women.Conclusions：这些研究结果表明，自杀行为的危险因素的重要性不同抑郁症的男性和女性。这些知识可能会改善自杀风险评估，并指导未来的自杀评估和预防研究。
Objective: Whether sex differences exist in clinical risk factors associated with suicidal behavior is unknown. The authors postulated that among men with a major depressive episode, aggression, hostility, and history of substance misuse increase risk for future suicidal behavior, while depressive symptoms, childhood history of abuse, fewer reasons for living, and borderline personality disorder do so in depressed women.Method: Patients with DSM-III-R major depression or bipolar disorder seeking treatment for a major depressive episode ( N=314) were followed for 2 years. Putative predictors were tested with Cox proportional hazards regression analysis.Results: During follow-up, 16.6% of the patients attempted or committed suicide. Family history of suicidal acts, past drug use, cigarette smoking, borderline personality disorder, and early parental separation each more than tripled the risk of future suicidal acts in men. For women, the risk for future suicidal acts was sixfold greater for prior suicide attempters; each past attempt increased future risk threefold. Suicidal ideation, lethality of past attempts, hostility, subjective depressive symptoms, fewer reasons for living, comorbid borderline personality disorder, and cigarette smoking also increased the risk of future suicidal acts for women.Conclusions: These findings suggest that the importance of risk factors for suicidal acts differs in depressed men and women. This knowledge may improve suicide risk evaluation and guide future research on suicide assessment and prevention.