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首页> 外文期刊>International Journal of General Medicine >Factors related to suicide attempts among individuals with major depressive disorder
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Factors related to suicide attempts among individuals with major depressive disorder

机译：与重度抑郁症患者自杀未遂相关的因素

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Background: Major depressive disorder (MDD) is the leading cause of suicidal behaviors. Risk related to suicide attempts among individuals with MDD remains uninvestigated in upper northern Thailand, where the completed suicide rate is the highest in the nation.Objective: To examine risk related to suicide attempts among individuals with MDD.Methods: Individuals diagnosed with MDD using the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10), codes F32.x and F33.x, seeking care at Suanprung Psychiatric Hospital between October 2006 and May 2009 were eligible. All individuals with MDD admitted due to suicide attempts were defined as cases (n = 186), and four controls per case were selected from those who did not attempt suicide on the same day or within a week of case selection (n = 914). Their medical charts were reviewed for sociodemographic and clinical factors influencing suicide attempts using multivariable logistic regression analysis.Results: Factors related to suicide attempts were stressful life events (adjusted odds ratio [OR], 2.32; 95% confidence interval [CI]: 1.27–4.24), alcohol use (adjusted OR, 2.08; 95% CI: 1.29–3.34), intermittent or poor psychiatric medications adherence (adjusted OR, 2.25; 95% CI: 1.44–3.51), up to two previous suicide attempts (adjusted OR, 3.64; 95% CI: 2.32–5.71), more than two previous suicide attempts (adjusted OR, 11.47; 95% CI: 5.73–22.95), and prescribed antipsychotics (adjusted OR, 3.84; 95% CI: 2.48–5.95). Risk factors that were inversely related to suicide attempts were increasing years of MDD treatment; one to five years (adjusted OR, 0.22; 95% CI: 0.11–0.44), over five years (adjusted OR, 0.44; 95% CI: 0.23–0.86), and antidepressant prescribed (norepinephrine [NE] and/or serotonin reuptake inhibitors [SRIs], adjusted OR, 0.28; 95% CI: 0.10–0.78). The final model explained 85.8% probability of suicide attempts.Conclusion: Seven key factors suggested from this study may facilitate clinicians to identify individuals with MDD at risk of suicide attempt and provide them close monitoring, timely assessment, and intensive treatments.
机译：背景：重度抑郁症（MDD）是自杀行为的主要原因。在泰国北部，尚未完成有关MDD患者自杀未遂风险的调查，该地区的自杀率是全国最高的。目的：检查与MDD患者自杀未遂相关的风险方法：使用MDD诊断为MDD的患者在2006年10月至2009年5月间到Suanprung精神病医院就诊的国际疾病和相关健康问题统计分类第十次修订版（ICD-10），代码为F32.x和F33.x。将所有因自杀未遂而入院的MDD患者定义为病例（n = 186），并从病例选择当天或一周内未尝试自杀的那些患者中选择四个对照（n = 914）。使用多因素logistic回归分析对他们的医学图表进行了社会人口统计学和临床​​因素的自杀评估。结果：与自杀未遂相关的因素是应激性生活事件（调整后的优势比[OR]，2.32; 95％置信区间[CI]：1.27– 4.24），饮酒（调整后的OR，2.08; 95％CI：1.29-3.34），间歇性或不良精神药物依从性（调整后的OR，2.25; 95％CI：1.44-3.51），以及至多两次之前的自杀未遂（调整后的OR） ，3.64; 95％CI：2.32-5.71），两次以上的自杀未遂（调整后OR，11.47; 95％CI：5.73-22.95）和开具抗精神病药（调整后OR，3.84; 95％CI：2.48-5.95） 。与自杀未遂成反比的危险因素是MDD治疗年限的增加。一到五年（调整后的OR，0.22; 95％CI：0.11-0.44），五年以上（调整后的OR，0.44; 95％CI：0.23-0.86），并开具抗抑郁药（去甲肾上腺素[NE]和/或5-羟色胺再摄取）抑制剂[SRI]，调整后的OR为0.28; 95％CI：0.10-0.78）。最终模型解释了尝试自杀的可能性为85.8％。结论：这项研究提出的七个关键因素可以帮助临床医生识别罹患自杀未遂风险的MDD患者，并对其进行密切监测，及时评估和强化治疗。

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