临床试验研究自杀风险降低:谁被排除在参与之外
概括
减少自杀风险的临床试验排除了大多数高风险患者,原因是精神病和物质使用等常见标准. 这限制了概括性,强调了在紧急精神病学环境中需要更具包容性的研究.
科学领域:
- 临床心理学 临床心理学
- 精神病学研究 精神病学研究
- 公共卫生 公共卫生
背景情况:
- 临床试验中的排除标准可以限制研究结果对现实世界患者群体的概括性.
- 这在研究减少自杀风险的研究中尤其令人担忧,在这些研究中,广泛适用性至关重要.
研究的目的:
- 在临床试验中确定和量化常见的排除标准,以减少自杀风险.
- 估计这些标准对高风险成年人的急诊室患者资格的影响.
主要方法:
- 在PubMed的系统文献搜索,寻找最近关于降低自杀风险的临床试验.
- 定性内容分析以确定常见的排除标准.
- 在急诊部精神病学评估样本中对成年患者的回顾性图表审查.
主要成果:
- 分析了27项试验;常见的排除标准包括精神病 (77.8%),认知问题 (66.7%) 和物质使用 (63.0%).
- 在临床样本 (N=232) 中,精神病和物质使用标准将分别排除53.0%和67.2%的患者.
- 只有5.6%的急诊精神病患者符合使用这些常见排除标准的试验资格.
结论:
- 自杀风险降低的临床试验对高风险紧急精神病患者的概括性较低.
- 需要进行包括精神病和物质滥用个体在内的试验,以提高对这一群体的相关性.
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