Depression and suicidal behavior in adolescent inpatients with obsessive compulsive disorder
Depression and suicidal behavior in adolescent inpatients with obsessive compulsive disorder
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DOI：
10.1016/s0165-0327(02)00038-1
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发表时间：
2003-07-01
影响因子：
6.6
通讯作者：
Weizman, A
中科院分区：
文献类型：
--
作者：
Apter, A;Horesh, N;Weizman, A
背景：探讨青少年精神科住院患者强迫症(OCD)自杀行为的发生率及其相关性。方法：共有348名青少年，代表着连续住进青少年住院部，被评估。在这些患者中，40名患者患有强迫症，118名患者患有精神分裂症，59名患者患有情感障碍，81名患者患有品行障碍，50名患者患有饮食障碍。此外，对87名正常社区控制者进行了评估。采用儿童自杀潜在量表(CSPs)、贝克抑郁量表(Beck Depression Inventory)、冲动控制量表(ImPulse Control Scale)、状态-特质焦虑量表、尤多夫斯基外显攻击性量表(Yudowsky Open Attative Scale)对所有受试者进行自杀行为、抑郁、冲动、焦虑和攻击性评定。结果：包括强迫症在内的所有精神疾病患者的抑郁、焦虑和冲动水平均显著高于对照组。然而，在强迫症受试者中，自杀未遂的比率要低得多。此外，强迫症患者的自杀行为水平与抑郁水平呈显著负相关，而其他所有受试者的自杀行为水平与抑郁水平呈显著正相关。局限性：这项研究着眼于参考人群，不能将其推广到门诊和社区样本。很难区分原发诊断和合并诊断，而且一些发现是基于小样本，因此可能容易出现I型错误。结论：虽然自杀意念和抑郁症状在强迫症青少年住院患者中很常见，但他们似乎受到保护，不会有自杀企图。自杀行为和抑郁之间的反向关系可能意味着，自杀行为在某些方面与其他患有精神疾病的青少年的自杀行为有质的不同。(C)2002年，爱思唯尔科学公司出版。
Background: To investigate the prevalence and correlations of suicidal behavior in obsessive compulsive disorder (OCD) among adolescent psychiatric inpatients. Methods: A total of 348 adolescents, representing consecutive admissions to an adolescent inpatient unit, were assessed. Of these, 40 patients had OCD, 118 had schizophrenia, 59 had an affective disorder, 81 had a conduct disorder and 50 had an eating disorder. In addition, 87 normal community controls were assessed. All subjects were assessed for suicidal behavior by the Childhood Suicide Potential Scale (CSPS), for depression by the Beck Depression Inventory, for impulsiveness by the Impulse Control Scale, for anxiety by the State-Trait Anxiety Scale and for aggression by the Yudowsky Overt Aggression Scale. Results: All the psychiatrically ill subjects, including those with OCD, had high levels of depression, anxiety and impulsiveness, which were far higher than those of the controls. The rate of attempted suicide was, however, much lower in the OCD subjects. In addition, there was a significant inverse correlation between suicidal behavior levels on the CSPS and depression in the OCD subjects, while all other subjects showed the expected significant positive correlation between level of suicidal behavior and depression. Limitations: This study looked at a referred population and generalization to outpatient and community samples cannot be made. Distinguishing between the primary and the comorbid diagnosis is difficult and some findings are based on small sample size and therefore may be vulnerable to type I error. Conclusions: Although suicidal ideation and depressive symptoms are common in OCD adolescent inpatients, they seem to be protected against suicide attempts. The inverse relationship between suicidal behavior and depression may mean that suicidal behavior is, in some ways, qualitatively different from that seen in other psychiatrically ill adolescents. (C) 2002 Published by Elsevier Science B.V.