高危患者按诊断分层的自杀行为发生率。

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research Pub Date : 2025-01-01 DOI:10.1016/j.psychres.2024.116310

Leandro Nicolás Grendas , Alejandro Olaviaga , Luciana Carla Chiapella , Federico Manuel Daray

{"title":"高危患者按诊断分层的自杀行为发生率。","authors":"Leandro Nicolás Grendas , Alejandro Olaviaga , Luciana Carla Chiapella , Federico Manuel Daray","doi":"10.1016/j.psychres.2024.116310","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Psychiatric diagnoses are known to increase suicide risk, but whether this risk varies across specific disorders remains unclear. Previous studies have often relied on retrospective designs or population-based databases, limiting comparability due to heterogeneous methodologies and follow-up periods.</div></div><div><h3>Aims</h3><div>This study aimed to compare the incidence rates of unfavorable events (suicide or suicide attempts) among high-risk patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia over a 24-month follow-up period.</div></div><div><h3>Methods</h3><div>This secondary analysis was conducted as part of a multicenter prospective cohort study involving 324 patients admitted to emergency departments for suicidal ideation or a recent suicide attempt. Clinical evaluations were performed at baseline and every six months to assess for unfavorable events. Additionally, Kaplan-Meier curves were estimated for each diagnosis, and Cox regression models were used to evaluate whether the diagnosis is associated with unfavorable events, adjusted for covariates such as age, history of childhood sexual abuse, and number of previous suicide attempts.</div></div><div><h3>Results</h3><div>The incidence rates of suicide attempts were 27,000, 20,400, and 21,100 per 100,000 person-years for patients with MDD, BD, and Schizophrenia, respectively, while suicide rates were 1,600 per 100,000 person-years across all groups. No statistically significant differences were found in the risk of unfavorable events among diagnostic groups (<em>p</em> = 0.653), as confirmed by Kaplan-Meier survival analysis and Cox regression models.</div></div><div><h3>Conclusions</h3><div>Over a 2-year follow-up, psychiatric diagnosis alone did not predict significant differences in unfavorable events rates. Comprehensive suicide risk assessments should prioritize individual risk profiles over diagnostic categories. These findings underscore the importance of integrating biopsychosocial factors in suicide prevention strategies for high-risk psychiatric populations.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"343 ","pages":"Article 116310"},"PeriodicalIF":4.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence rate of suicidal behavior stratified by diagnosis among high-risk patients\",\"authors\":\"Leandro Nicolás Grendas , Alejandro Olaviaga , Luciana Carla Chiapella , Federico Manuel Daray\",\"doi\":\"10.1016/j.psychres.2024.116310\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Psychiatric diagnoses are known to increase suicide risk, but whether this risk varies across specific disorders remains unclear. Previous studies have often relied on retrospective designs or population-based databases, limiting comparability due to heterogeneous methodologies and follow-up periods.</div></div><div><h3>Aims</h3><div>This study aimed to compare the incidence rates of unfavorable events (suicide or suicide attempts) among high-risk patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia over a 24-month follow-up period.</div></div><div><h3>Methods</h3><div>This secondary analysis was conducted as part of a multicenter prospective cohort study involving 324 patients admitted to emergency departments for suicidal ideation or a recent suicide attempt. Clinical evaluations were performed at baseline and every six months to assess for unfavorable events. Additionally, Kaplan-Meier curves were estimated for each diagnosis, and Cox regression models were used to evaluate whether the diagnosis is associated with unfavorable events, adjusted for covariates such as age, history of childhood sexual abuse, and number of previous suicide attempts.</div></div><div><h3>Results</h3><div>The incidence rates of suicide attempts were 27,000, 20,400, and 21,100 per 100,000 person-years for patients with MDD, BD, and Schizophrenia, respectively, while suicide rates were 1,600 per 100,000 person-years across all groups. No statistically significant differences were found in the risk of unfavorable events among diagnostic groups (<em>p</em> = 0.653), as confirmed by Kaplan-Meier survival analysis and Cox regression models.</div></div><div><h3>Conclusions</h3><div>Over a 2-year follow-up, psychiatric diagnosis alone did not predict significant differences in unfavorable events rates. Comprehensive suicide risk assessments should prioritize individual risk profiles over diagnostic categories. These findings underscore the importance of integrating biopsychosocial factors in suicide prevention strategies for high-risk psychiatric populations.</div></div>\",\"PeriodicalId\":20819,\"journal\":{\"name\":\"Psychiatry Research\",\"volume\":\"343 \",\"pages\":\"Article 116310\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychiatry Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S016517812400595X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychiatry Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S016517812400595X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

摘要

背景：已知精神病诊断会增加自杀风险，但这种风险是否因特定疾病而异尚不清楚。以前的研究通常依赖于回顾性设计或基于人群的数据库，由于方法和随访期的异质性，限制了可比性。目的：本研究旨在比较重度抑郁障碍（MDD）、双相情感障碍（BD）和精神分裂症高危患者在24个月的随访期间的不良事件（自杀或自杀企图）发生率。方法：这项二次分析是一项多中心前瞻性队列研究的一部分，涉及324名因自杀意念或近期自杀未遂而进入急诊科的患者。在基线和每六个月进行临床评估以评估不利事件。此外，对每个诊断进行Kaplan-Meier曲线估计，并使用Cox回归模型评估诊断是否与不利事件相关，调整协变量如年龄、儿童期性虐待史和以前的自杀企图次数。结果：重度抑郁症、双相障碍和精神分裂症患者的自杀企图发生率分别为每10万人年27,000、20,400和21,100，而所有组的自杀率为每10万人年1,600。Kaplan-Meier生存分析和Cox回归模型证实，诊断组间不良事件发生风险差异无统计学意义（p = 0.653）。结论：经过2年的随访，单独的精神病学诊断不能预测不良事件发生率的显著差异。综合自杀风险评估应优先考虑个人风险概况而不是诊断类别。这些发现强调了在高危精神病人群自杀预防策略中整合生物心理社会因素的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Incidence rate of suicidal behavior stratified by diagnosis among high-risk patients

Background

Psychiatric diagnoses are known to increase suicide risk, but whether this risk varies across specific disorders remains unclear. Previous studies have often relied on retrospective designs or population-based databases, limiting comparability due to heterogeneous methodologies and follow-up periods.

Aims

This study aimed to compare the incidence rates of unfavorable events (suicide or suicide attempts) among high-risk patients with Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia over a 24-month follow-up period.

Methods

This secondary analysis was conducted as part of a multicenter prospective cohort study involving 324 patients admitted to emergency departments for suicidal ideation or a recent suicide attempt. Clinical evaluations were performed at baseline and every six months to assess for unfavorable events. Additionally, Kaplan-Meier curves were estimated for each diagnosis, and Cox regression models were used to evaluate whether the diagnosis is associated with unfavorable events, adjusted for covariates such as age, history of childhood sexual abuse, and number of previous suicide attempts.

Results

The incidence rates of suicide attempts were 27,000, 20,400, and 21,100 per 100,000 person-years for patients with MDD, BD, and Schizophrenia, respectively, while suicide rates were 1,600 per 100,000 person-years across all groups. No statistically significant differences were found in the risk of unfavorable events among diagnostic groups (p = 0.653), as confirmed by Kaplan-Meier survival analysis and Cox regression models.

Conclusions

Over a 2-year follow-up, psychiatric diagnosis alone did not predict significant differences in unfavorable events rates. Comprehensive suicide risk assessments should prioritize individual risk profiles over diagnostic categories. These findings underscore the importance of integrating biopsychosocial factors in suicide prevention strategies for high-risk psychiatric populations.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Psychiatry Research 医学-精神病学

CiteScore

17.40

自引率

1.80%

发文量

527

审稿时长

57 days

期刊介绍： Psychiatry Research offers swift publication of comprehensive research reports and reviews within the field of psychiatry. The scope of the journal encompasses: Biochemical, physiological, neuroanatomic, genetic, neurocognitive, and psychosocial determinants of psychiatric disorders. Diagnostic assessments of psychiatric disorders. Evaluations that pursue hypotheses about the cause or causes of psychiatric diseases. Evaluations of pharmacologic and non-pharmacologic psychiatric treatments. Basic neuroscience studies related to animal or neurochemical models for psychiatric disorders. Methodological advances, such as instrumentation, clinical scales, and assays directly applicable to psychiatric research.