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　　标题：NewResearchIdentifiesBehaviorPatternsThatPrecedeSuicideAttempts
　　source：psychcentral丨byJaniceWood
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　　Amultinationalstudyhasidentifiedthebehaviorpatternsthatprecedemanysuicideattempts。
　　Accordingtoresearchers，thiscouldhelpleadtochangesinthecareofpatientsaffectedwithdepression。
　　AccordingtotheWorldHealthOrganization（WHO），morethan800，000peoplecommitsuicideeveryyear，withperhaps20timesthatnumberattemptingsuicide。Suicideisoneoftheleadingcausesofdeathintheyoung。Forexample，intheUK，itistheleadingcauseofdeathinmenundertheageof35，accordingtoWHOofficials。
　　ThosestatisticsfueledtheinternationalBRIDGEIIMIXstudylookingatdepressionandsuicide。Theresearchersevaluated2，811patientssufferingfromdepression，including628whohadalreadyattemptedsuicide。
　　Eachpatientwasinterviewedbyapsychiatristasifitwereastandardevaluationofamentallyillpatient。Parametersincludedprevioussuicideattempts，familyhistory，currentandprevioustreatment，patients’clinicalpresentation，andhowtheyscoredonthestandardGlobalAssessmentofFunctioningscale。
　　Theresearcherslookedespeciallyatthecharacteristicsandbehaviorsofthosewhohadattemptedsuicide，andcomparedthesetodepressedpatientswhohadnotattemptedsuicide。
　　Whattheyfoundisthatcertainpatternsarecommonbeforesuicideattempts。
　　Wefoundthat‘depressivemixedstates’oftenprecededsuicideattempts，saidDr。DinaPopovicoftheHospitalClinicDeBarcelonainBarcelona，Spain。Adepressivemixedstateiswhereapatientisdepressed，butalsohassymptomsofexcitation，ormania。
　　Wefoundthissignificantlymoreinpatientswhohadpreviouslyattemptedsuicidethanthosewhohadnot。Infact，40percentofallthedepressedpatientswhoattemptedsuicidehadamixedepisoderatherthanjustdepression。Allthepatientswhosufferfrommixeddepressionareatmuchhigherriskofsuicide。
　　TheresearchersalsofoundthatthestandardDiagnosticandStatisticalManualofMentalDisorders（DSM）criteriaidentifiedonly12percentofthepatientsshowingmixedstates。
　　Ourmethodsshowed40percentofatriskpatients，Popovicnoted。Thismeansthatthestandardmethodsaremissingalotofpatientsatriskofsuicide。
　　Inasecondanalysisofthefigures，theresearchersfoundthattheriskofattemptingsuicideis50percenthigherifadepressedpatientpresentsanyofthefollowingsymptoms：
　　Riskybehavior（e。g。recklessdriving，promiscuousbehavior）；
　　Psychomotoragitation（pacingaroundaroom，wringingone’shands，pullingoffclothing，andputtingitbackonandothersimilaractions）；or
　　Impulsivity（actingonawhim，displayingbehaviorcharacterizedbylittleornoforethought，reflection，orconsiderationoftheconsequences）。
　　Inouropinion，assessingthesesymptomsineverydepressedpatientweseeisextremelyimportant，andhasimmensetherapeuticalimplications，Popovicsaid。
　　Mostofthesesymptomswillnotbespontaneouslyreferredbythepatient。Theclinicianneedstoinquiredirectly，andmanycliniciansmaynotbeawareoftheimportanceoflookingatthesesymptomsbeforedecidingtotreatdepressedpatients。
　　SheaddedthatthisisanimportantmessageforallcliniciansfromtheGPswhoseedepressedpatientsandmaynotpayenoughattentiontothesesymptoms，whicharenotalwaysreportedspontaneouslybythepatients，throughtosecondaryandtertiarylevelclinicians。Inhighlyspecializedtertiarycenters，cliniciansworkingwithbipolarpatientsareusuallymoreawareofthis，butthatpracticeneedstoextenttoalllevels。
　　Thestrengthofthestudy，accordingtoPopovic，isit’snotaclinicaltrial，withidealpatientsit’sabigstudy，fromtherealworld。