Awareness of disorder and suicide risk in the treatment of schizophrenia: Results of the international suicide prevention trial
Awareness of disorder and suicide risk in the treatment of schizophrenia: Results of the international suicide prevention trial
复制标题
DOI：
10.1176/appi.ajp.161.8.1494
复制
发表时间：
2004-08-01
影响因子：
17.7
通讯作者：
Meltzer, HY
中科院分区：
文献类型：
--
作者：
Bourgeois, M;Swendsen, J;Meltzer, HY
目的：精神分裂症具有自杀危险性高、对疾病的认知度低的特点。虽然意识的药物治疗的依从性和临床结果的好处，目前还不清楚它可能与自杀风险在此population.Method：这个多中心的调查评估了980例精神分裂症或情感性精神障碍患者的意识和自杀相关的行为。患者进行了为期2年的随访，并评估了自杀相关events.Results：在基线的精神状况的认识与自杀事件的风险增加的后续。这种影响是由抑郁和绝望水平介导的。相比之下，与治疗相关的意识的变化降低了自杀的风险。结论：虽然有些患者可能会成为抑郁症后，承认他们的疾病的临床障碍，治疗相关的意识的变化通常与积极的结果相对于自杀风险。这些临床变量的复杂相互作用和中介效应需要仔细监测。
Objective: Schizophrenia is characterized by high suicide risk and low awareness of disorder. Although awareness has benefits for medication compliance and clinical outcome, it is unclear how it may relate to suicide risk in this population.Method: This multicenter investigation assessed awareness and suicide-related behavior in 980 patients with schizophrenia or schizoaffective disorder. Patients were followed over 2 years and assessed by blinded raters for suicide-related events.Results: Awareness of psychiatric condition at baseline was associated with increased risk of suicide events over the follow-up. This effect was mediated by depression and hopelessness levels. By contrast, changes in awareness associated with treatment decreased the risk of suicide.Conclusions: Although some patients may become depressed after acknowledging the clinical handicaps of their disorder, treatment-related changes in awareness are generally associated with a positive outcome relative to suicide risk. The complex interactions and mediation effects of these clinical variables require careful monitoring.