Clinical predictors of suicidal acts after major depression in bipolar disorder: a prospective study
Clinical predictors of suicidal acts after major depression in bipolar disorder: a prospective study
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DOI：
10.1111/j.1399-5618.2006.00340.x
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发表时间：
2006-10-01
影响因子：
5.4
通讯作者：
Mann, J. John
中科院分区：
文献类型：
--
作者：
Galfalvy, Hanga;Oquendo, Maria A.;Mann, J. John
目的：本研究确定了自杀行为的临床预测因素，在2年的随访期间，双相情感障碍患者提出了一个重性抑郁发作（MDE）。方法：64例DSM-III-R双相情感障碍患者进行了评估，在介绍治疗的MDE。通过使用t检验、Wilcoxon检验或卡方检验对个体解释变量的独立性进行比较，确定既往自杀行为的相关性。假定的预测因素的尝试在随访期间分别进行了测试，使用考克斯比例风险回归analysis.Results：12 64例患者至少有一个自杀企图在随访期间，其中5人试图在第2个月和7左右或不久后的1年随访访视。所有的自杀者都有自杀未遂的历史。大多数未来自杀行为的预测因子与过去的自杀行为相关。自杀行为和共病的边缘型人格障碍的家族史预测早期尝试，而年轻的年龄，高的敌意分数，过去的尝试，主观悲观的抑郁症和自杀意念，以及很少有报道的原因生活预测自杀actions在整个period.Conclusion：在这个数据集的双相患者，我们注意到一个有趣的图片的两个集群的自杀企图。敌意是最大的风险因素。这些研究结果可能对确定高危患者和临床干预措施（包括积极的药物预防）的时机有影响，以防止抑郁症的复发或复发。
Objective: This study determined the clinical predictors of suicidal behavior during a 2-year follow-up of patients with bipolar disorder presenting with a major depressive episode (MDE).Method: Sixty four patients with DSM-III-R bipolar disorder were assessed at presentation for treatment of an MDE. Correlates of past suicidal behavior were determined by comparing patients with and without a history of suicide attempts using a t-test, Wilcoxon test or chi-squared test of independence on individual explanatory variables. Putative predictors of attempts during the follow-up period were tested separately using Cox proportional hazards regression analysis.Results: Twelve of 64 patients had at least one suicide attempt in the follow-up period, five of them attempted in the first 2 months and seven around or shortly after the 1-year follow-up visit. All attempters had a history of past suicide attempts. Most predictors of future suicidal behavior were correlates of past suicidal behavior. Family history of suicide acts and comorbid borderline personality disorder predicted early attempts, while younger age, high hostility scores, number of past attempts, subjective pessimism as reflected in depression and suicidal ideation, and few reported reasons for living predicted suicidal acts during the whole period.Conclusion: In this data set of bipolar patients we noted an intriguing picture of two clusters of suicide attempts. Hostility was the strongest risk factor. These findings may have implications in both the identification of at-risk patients and the timing of clinical interventions including aggressive pharmacotherapeutic prophylaxis to prevent relapse or recurrence of depressive symptomatology.