在治疗和二前期间,双极性疾病中存在自杀风险
Frederick K Goodwin1, Bruce Fireman, Gregory E Simon
1Department of Psychiatry, George Washington University Medical Center, Washington, DC 20037, USA. fgoodwin@mfa.gwu.edu
JAMA
|September 18, 2003
概括
与二极性障碍患者相比,在用治疗时,自杀企图和死亡的风险较低. 这项研究强调了这些常见的情绪稳定剂之间的自杀风险的关键差异.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 现有研究表明,治疗可能会降低双相情感障碍患者的自杀风险.
- 没有先前的研究调查了与divalproex相关的自杀风险,这是一种在美国广泛处方的情绪稳定剂.
研究的目的:
- 在双相情感障碍患者中,比较和二普雷克斯治疗之间的自杀企图和自杀死亡风险.
- 评估与divalproex关于自杀行为的比较安全概况.
主要方法:
- 使用加利福尼亚州和华盛顿州两个大型综合健康计划的数据进行了一项回顾性队列研究.
- 分析了20638名健康计划会员的基于人口的样本,这些会员被诊断患有双相情感障碍,并在1994年至2001年期间被处方,双或卡巴马泽平.
- 自杀企图是通过医院出院或急诊诊断发现的,自杀死亡是通过死亡证明证书确认的.
主要成果:
- 与相比,未经调整的分析显示,与相比,在divalproex治疗期间,急诊室自杀未遂,因自杀未遂住院和自杀死亡率显著更高.
- 在调整了人口和临床因素后,divalproex的自杀死亡风险是 (95% CI,1.1-6.3;P =.03) 的2.7倍.
- 对非致命的自杀企图的调整后危险比为1.8 (95% CI,1.4-2.2;P<.001) 对于急诊诊断和1.7 (95% CI,1.2-2.3;P=.002) 对于住院治疗.
结论:
- 与被诊断患有双相情感障碍的患者中,与divalproex相比,使用的治疗与自杀企图和自杀死亡的风险较低.
- 这些发现强调了考虑药物选择在控制双相情感障碍患者自杀风险方面的重要性.
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