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Suicide Behavior Following PHQ-9 Screening Among Individuals With Substance Use Disorders

机译:PHQ-9筛选的自杀行为在具有物质使用障碍的个人中

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摘要

Objectives: Individuals with substance use disorders (SUD) are at risk for suicide, but no studies have assessed whether routinely administered screeners for suicidal ideation accurately identify outpatients with SUD who are at risk for suicide attempt or death. Methods: Data from more than 186,000 visits by over 55,000 patients with mental health and SUD diagnoses receiving care in 7 health systems were analyzed to determine whether responses to item 9 of the 9-item Patient Health Questionnaire, which assesses frequency of thoughts of death and self-harm, are associated with suicide outcomes after an outpatient visit. Odds of suicide attempt or death were computed using generalized estimating equations. Results: In bivariate analyses, a nearly 5-fold risk was observed for patients answering “nearly every day” relative to “not at all” among individuals who made a suicide attempt within 90 days (4.9% vs 1.1%; χ~(2)?=?1151, P ?
机译:目标:患有物质使用障碍(SUD)的个体有自杀风险,但没有研究评估定期进行自杀意念筛查是否能准确识别出有自杀未遂或死亡风险的SUD门诊患者。方法:对7个卫生系统中接受护理的55000多名精神健康和SUD诊断患者186000多次就诊的数据进行分析,以确定对9项患者健康问卷第9项的回答是否与门诊就诊后的自杀结果相关。9项患者健康问卷评估了死亡和自我伤害的想法频率。自杀未遂或死亡的几率用广义估计方程计算。结果:在双变量分析中,在90天内尝试自杀的患者中,回答“几乎每天”的风险是回答“完全没有”的风险的近5倍(4.9%比1.1%;χ2)?=?1151页?0.0001). 在90天内有近一半的就诊(46%)发生自杀未遂,患者的回答是“完全没有”在逻辑模型中,与“完全没有”相比,所有其他反应都与90天内自杀未遂或死亡的几率更高有关。完全调整后的模型减弱了结果,但“几乎每天”报告的自杀未遂(AOR?=?3.24,CI:2.69–3.91)和自杀死亡(AOR?=?5.67,CI:2.0–16.1)的几率仍然很高结论:在SUD患者中,患者健康问卷第9项反应的增加预示着后续自杀行为的风险增加,应及时进行干预。然而,临床医生应该意识到,那些报告“完全没有”的人并不能避免随后的自杀风险。

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