Suicidal Ideation in Adolescents: Understanding Results from Screening with the PHQ-9M and the PSC-17P.
Suicidal Ideation in Adolescents: Understanding Results from Screening with the PHQ-9M and the PSC-17P.
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DOI：
10.1097/dbp.0000000000001063
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发表时间：
2022-08-01
影响因子：
2.4
通讯作者：
Murphy, J. Michael
中科院分区：
文献类型：
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作者：
Holcomb, Juliana M.;Dutta, Anamika;Bergmann, Paul;Riobueno-Naylor, Alexa;Haile, Haregnesh;Benheim, Talia S.;Sturner, Raymond;Howard, Barbara;Jellinek, Michael;Murphy, J. Michael
为了帮助儿科医生了解和应对青少年中的自杀意念(SI)，基于两项广泛使用的筛查措施的数据，这两项筛查措施在全国大样本中评估了自杀意念和其他心理社会脆弱性。青少年(11-17岁)在探视健康儿童之前，使用CHADIS软件完成了针对青少年而修改的PHQ-9(PHQ-9M)。问题9询问过去两周的SI。他们的父母填写了儿科症状检查表(PSC-17P)，其中筛选了广泛的心理社会问题。卡方分析和单因素方差分析评估了SI和心理社会问题之间的关系。在5411名青少年中，266名(4.9%)报告在过去两周内至少有几天出现SI。在SI青少年中，187人(70.3%)在PHQ-9M(≥10)上有中度至极重度抑郁，68.1%在至少一个问题子量表上处于危险状态，59.7%在PSC-17P内在量表上，42.9%在PSC-17P总体上，20.6%在PSC-17P外化问题上，18.5%在PSC-17P注意上。在几乎所有支持SI的亚样本中，35.7%的人有过自杀未遂。PHQ-9M确定了大约5%报告偶尔到频繁出现SI的青少年的临床异质性亚群。PSC-17P证实了他们高度的总体风险，并提供了额外的信息，可以帮助儿科医生评估临床严重程度和一系列心理社会问题。鉴于我们对如何预测和预防青少年个体自杀的了解有限，筛查的重点应该是识别和帮助任何类型的慢性心理社会脆弱患者。
To help pediatricians understand and respond to suicidal ideation (SI) in adolescents based on data from two widely used screening measures that assessed SI and other psychosocial vulnerabilities in a large, national sample. Adolescents (ages 11-17) completed the PHQ-9 Modified for Teens (PHQ-9M) using the CHADIS software prior to their well child visits. Question 9 asks about past two-week SI. Their parents filled out the Pediatric Symptom Checklist (PSC-17P), which screens for a broad range of psychosocial problems. Chi-square analyses and one-way ANOVAs assessed the relationship between SI and psychosocial problems. Among 5,411 adolescents, 266 (4.9%) reported SI at least several days in the past two weeks. Among adolescents with SI, 187 (70.3%) reported moderate to very severe depression on the PHQ-9M (≥10), 68.1% were at-risk on at least one PSC-17P problem subscale, 59.7% on the PSC-17P internalizing scale, 42.9% on PSC-17P overall, 20.6% on PSC-17P externalizing, and 18.5% on PSC-17P attention. Within the subsample endorsing SI nearly all days, 35.7% had a former suicide attempt. The PHQ-9M identifies a clinically heterogeneous subset of approximately 5% of adolescents who report occasional to frequent SI. The PSC-17P corroborates their high degree of overall risk and offers additional information that can help pediatricians assess clinical severity and range of psychosocial problems. Given our limited knowledge of how to predict and prevent an individual adolescent’s suicide, the focus of screening should be to identify and help the subset of patients with chronic psychosocial vulnerability of any type.