论文部分内容阅读
Background: Depressed inpatients are a high-risk group for suicidal behaviour to progress along the continuum of ideation to attempt or eventual suicide.Objective: To determine the progression, sociodemographic and clinical predictive risk factors of future suicidal behaviour among inpatients with a depressive disorder.Methods: A naturalistic prospective study of (consecutive admissions) all patients admitted to the Universiti Kebangsaan Malaysia Medical Centre Psychiatric wards for a depressive disorder was conducted between May 2007 and December 2008.Sixty-six patients who were diagnosed with a depressive disorder (SCID-CV) were assessed longitudinally for a year in terms of suicidal attempt, suicidal ideation (SSI), severity of depression (BDI), recent life event changes (Social Readjustment Rating Scale, SRRS) and other relevant factors.Results: This study showed that 21.4% of baseline suicidal ideators progressed to a suicide attempt within an average duration of 6.6 months.All patients who attempted suicide within this follow-up period had baseline suicidal ideation.Factors significantly associated with this progression from suicidal ideation to suicide attempt were previous psychiatric admission, higher severity of suicidal ideation, persistent depression, hopelessness and recent life event changes.Independent predictors of a future suicide attempt were higher severity of depression (OR=1.452, 95% Cl=1.005-2.098), substance dependence disorder (HR=12.077, 95% Cl=2.553-57.124), previous suicide attempt (HR=4.602, 95% Cl=1.004-21.098) and severity of suicidal ideation (HR=1.132, 95% Cl=1.039-1.234).The greatest risk for a future suicide attempt was within 5 months post-discharge from a psychiatric ward.Conclusion: The findings were generally consistent with existing studies and highlight the role of co-morbid substance dependence disorder in the context of persistent depression as significant risk factors for suicidal behaviour.Suicidal ideation was shown to be a prerequisite for future suicide attempt in depressed inpatients.The small sample size is a limitation in this study.