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首页> 外文期刊>The journal of clinical psychiatry >Suicide in primary affective disorders revisited: a systematic review by treatment era.
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Suicide in primary affective disorders revisited: a systematic review by treatment era.

机译：再次探讨原发性情感障碍中的自杀：按治疗时代进行的系统回顾。

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BACKGROUND: We reviewed suicide rates in affective disorder and their variation with electroconvulsive therapy (ECT) and antidepressant availability. METHOD: Suicide rates were calculated from 75 follow-up studies, identified by systematic literature searches and analyzed for differences over time eras characterized by the availability of specific treatments. DATA SOURCES AND STUDY SELECTION: MEDLINE, EMBASE, BIOSIS Previews, and Psychological Abstracts literature searches were conducted for the years 1966 to 1995. References from review articles identified from these sources from 1985 onward and textbook references were also included. Publications prior to 1966 were obtained from article references identified for the period 1966 to 1976 and reviews. Inclusion criteria were (1) articles written in English, French, or German; (2) sample size > 30; (3) age at recruitment between 18 and 64 years for each subject; (4) sample had to contain subjects hospitalized at time of recruitment; and (5) naturalistic follow-up of at least 6 months. RESULTS: Suicide rates decreased with longer follow-up periods. For follow-up periods over 20 years, the mean rate was 3.76/1,000 person-years (95% confidence interval [CI] = 2.35 to 5.17). Suicides accounted for 12.3% (95% CI = 8.52 to 16.04) of all deaths in samples in which 40% or more of patients had died. For studies with minimal overlap between eras, the mean suicide rate differed significantly between eras (pretreatment, before 1940: 6.3/1000; ECT treatment, 1940 to 1959: 5.7/1,000: antidepressant treatment, 1960 onward: 3.3/1,000; F = 31.4. df = 2,42; p < .001). CONCLUSION: The risk of suicide in follow-up studies of affective disorder has decreased compared to that reported in previous reviews. The availability of ECT and antidepressants may have contributed to this decrease, but prescription of these treatments cannot be assumed for all patients.
机译：背景：我们审查了情感障碍中的自杀率及其与电惊厥疗法（ECT）和抗抑郁药可用性的变化。方法：通过75项后续研究计算自杀率，通过系统文献检索确定自杀率，并分析以特定治疗手段为特征的一段时间内的差异。数据来源和研究选择：MEDLINE，EMBASE，BIOSIS Previews和Psychological Abstracts进行了1966年至1995年的文献搜索。还包括从1985年以来从这些资源中识别出的评论文章的参考文献和教科书参考文献。 1966年以前的出版物是从1966年至1976年期间确定的文章参考文献中获得的，并进行了综述。纳入标准为（1）用英语，法语或德语撰写的文章; （2）样本大小> 30; （3）每个科目的招募年龄在18至64岁之间; （4）样本必须包含招募时住院的受试者; （5）至少6个月的自然随访。结果：随着随访时间的延长，自杀率下降。对于20年以上的随访期，平均发生率为3.76 / 1,000人年（95％置信区间[CI] = 2.35至5.17）。在其中40％或更多的患者死亡的样本中，自杀占所有死亡的12.3％（95％CI = 8.52至16.04）。对于不同时代之间重叠最少的研究，不同时代之间的平均自杀率差异显着（预处理，1940年之前：6.3 / 1000; ECT治疗，1940年至1959年：5.7 / 1,000：抗抑郁药治疗，1960年以后：3.3 / 1,000; F = 31.4 df = 2,42; p <.001）。结论：与先前的综述相比，情感障碍随访研究中的自杀风险有所降低。 ECT和抗抑郁药的可获得性可能是造成这种下降的原因，但是不能为所有患者都开处方这些治疗方法。

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