Suicidal Intent and Method of Self-Harm: A Large-scale Study of Self-Harm Patients Presenting to a General Hospital
Suicidal Intent and Method of Self-Harm: A Large-scale Study of Self-Harm Patients Presenting to a General Hospital
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DOI：
10.1111/sltb.12168
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发表时间：
2015-12-01
影响因子：
3.2
通讯作者：
Hawton, Keith
中科院分区：
文献类型：
--
作者：
Haw, Camilla;Casey, Deborah;Hawton, Keith
来自牛津自杀未遂监测系统（2004-2011）的数据用于研究医院自我伤害的表现，其中获得自杀意图量表（SIS）评分（N = 4，840）。中位数回归用于控制年龄和性别的混杂效应。较高的估计中位SIS评分与年龄增加、男性性别、自我中毒与自伤、多种自伤方法与单独自伤、使用气体（主要是一氧化碳）、危险的自伤方法（包括上吊、枪击）以及使用酒精作为行为的一部分相关。对于自我中毒患者，服用片剂的数量与SIS总分之间存在相关性。与对乙酰氨基酚和含对乙酰氨基酚化合物的自我中毒相比，抗精神病药物的自我中毒与较低的SIS评分中位数相关，而抗抑郁药的估计中位数与对乙酰氨基酚相同。在自我伤害后6小时内使用酒精与较低的SIS评分相关。总之，某些自伤方法，特别是危险的自伤方法和气体自我中毒，与高意图有关，应提醒临床医生潜在的更高自杀风险。然而，除了使用气体外，自杀意图不能从用于自我中毒的药物类型推断出来。
Data from the Oxford Monitoring System for Attempted Suicide (2004-2011) were used to study hospital presentations for self-harm in which Suicidal Intent Scale (SIS) scores were obtained (N = 4,840). Regression of medians was used to control for the confounding effect of age and gender. Higher estimated median SIS scores were associated with increasing age, male gender, self-poisoning versus self-injury, multiple methods of self-harm versus self-injury alone, use of gas (mainly carbon monoxide), dangerous methods of self-injury (including hanging, gunshot), and use of alcohol as part of the act. For self-poisoning patients, there was a correlation between the number of tablets taken and the total SIS score. Compared with self-poisoning with paracetamol and paracetamol-containing compounds, self-poisoning with antipsychotics was associated with a lower median SIS score while antidepressants had the same estimated median as paracetamol. Use of alcohol within 6 hours of self-harm was associated with lower SIS scores. In conclusion, certain methods of self-harm, particularly dangerous methods of self-injury and self-poisoning with gas, were associated with high intent and should alert clinicians to potential higher risk of suicide. However, apart from use of gas, suicidal intent cannot be inferred from type of drugs used for self-poisoning.