背景:自杀意念变异性是指自杀意念的日内波动,最近被提议作为自杀风险的指标。然而,对其相关性和临床相关性知之甚少。
方法:我们使用生态瞬时评估对82名当前有活跃自杀意念的个体进行了实时自杀意念的特征研究。在21天内每天收集四次数据。潜在谱分析用于鉴定自杀意念的亚型。我们进一步检查了这些概况的社会人口统计学和临床相关性,以及它们与1年随访期间自杀未遂发生的关联。
结果:我们确定了三种自杀意念的“数字”表型,它们在频率上有所不同,思维的强度和变异性。配置文件是:高频,高强度,中等变异性(表型1),中/高频率,中等强度,高变异性(表型2),中等频率,低强度,低变异性(表型3)。表型1和2与基线时更差的临床特征相关(自杀意念和抑郁症状严重程度更高)。在随访期间自杀企图的几率增加,与表型3相比。表型1进一步表征为重复的自杀行为。
结论:确定了两种实时自杀意念的表型,似乎在不久的将来(12个月)具有更高的自杀行为风险。这些表型的特征是自杀意念的变异性更高,而且意念的强度和频率也更高。考虑到样本量小,这些配置文件的临床实用性仍有待证明。
BACKGROUND: Suicidal ideation variability refers to within-day fluctuations in suicidal ideation, and has recently been proposed as an indicator of suicide risk. However, not much is known yet about its correlates and clinical relevance.
METHODS: We examined characteristics of real-time suicidal ideation using Ecological Momentary Assessment in 82 individuals with current active suicidal ideation. Data were collected four times daily over 21 days. Latent profile analysis was used to identify subtypes of suicidal ideation. We further examined sociodemographic and clinical correlates of the profiles, and their association with the occurrence of suicide attempts during a 1-year follow-up.
RESULTS: We identified three \"digital\" phenotypes of suicidal ideation that differed on the frequency, intensity and variability of ideation. The profiles were: high frequency, high intensity, moderate variability (Phenotype 1), moderate/high frequency, moderate intensity, high variability (Phenotype 2), and moderate frequency, low intensity, low variability (Phenotype 3). Phenotypes 1 and 2 were associated with a worse clinical profile at baseline (higher suicidal ideation and depressive symptom severity), and increased odds of suicide attempt during follow-up, compared to Phenotype 3. Phenotype 1 was further characterized by repeated suicidal behavior.
CONCLUSIONS: Two phenotypes of real-time suicidal ideation were identified that appear to confer a higher risk of suicidal behavior in the near future (12 months). These phenotypes were characterized by higher variability of suicidal ideation-and also higher intensity and frequency of ideation. Considering the small sample size, the clinical usefulness of the profiles remains to be demonstrated.