¿Están los grandes repetidores adictos a los comportamientos suicidas? Are major repeater patients addicted to suicidal behavior?

Autores/as

  • Hilario Blasco-Fontecilla Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid Autonoma University, Madrid Consulting Asistencial Sociosanitario (CAS), Madrid,
  • Paula Artieda-Urrutia Department of Psychiatry, Ramon y Cajal University Hospital, Madrid
  • Nuria Berenguer-Elias Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid
  • Juan Manuel Garcia-Vega Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid
  • Monica Fernandez-Rodriguez Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid
  • Cesar Rodriguez-Lomas Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid
  • Isabel Gonzalez-Villalobos Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid
  • Luis Iruela-Cuadrado Villalba MHC, IDIPHIM, Department of Psychiatry, Puerta de Hierro University Hospital, CIBERSAM, Madrid Autonoma University, Madrid
  • José de Leon Mental Health Research Center at Eastern State Hospital, Lexington, KY

DOI:

https://doi.org/10.20882/adicciones.38

Palabras clave:

Grandes repetidores, comportamiento suicida, adicción, trastorno de personalidad límite. Major repeaters, suicidal behavior, addiction, borderline personality disorder.

Resumen

La escasa literatura existente sugiere que los “grandes repetidores” (individuos con 5 intentos de suicidio a lo largo de la vida) pueden ser considerados “adictos” a los comportamientos suicidas. Este estudio explora si los grandes repetidores sufren una adicción a los comportamientos suicidas usando 7 criterios: tolerancia (Criterio 1), abstinencia (Criterio 2), perdida de control (Criterio 3), problemas para dejar de tener o disminuir esos comportamientos (Criterio 4), uso de tiempo excesivo (Criterio 5), reducción importante de actividades (Criterio 6), y consecuencias físicas adversas (Criterio 7). La dependencia total a los comportamientos suicidas era diagnosticada si el sujeto cumplía 3 o más de los 7 criterios en los últimos 12 meses. Se trata de un estudio transversal realizado integramente en el Hospital Universitario Puerta de Hierro (Madrid, Spain), donde fueron recrutados 118 individuos que se presentaron en los servicios de urgencia por un intento de suicidio, incluyendo 8 grandes repetidores (7%, 8/118), siendo todos ellos mujeres. Se estimó si había asociaciones estadísticamente significativas y el tamaño del efecto con la razón de oportuniades y los intervalos de confianza (95%) entre cada uno de los criterios de adicción a los comportamientos suicidas, la dependencia fisiológica, y la dependencia total. Nuestra hipótesis se verificó, ya que los grandes repetidores presentaron con mayor frecuencia criterios para la dependencia a las conductas suicidas, OR=62.9 (6.4-615). Usamos un modelo de regresión logistica para estamiar el riesgo de la asociación entre ser un gran repetidor y la dependencia total corregido por diferentes variables. La edad, el trastorno de pánico sin agorafobia, el trastorno de personalidad límite, la historia de ingresos previos en unidad de hospitalización psiquiátrica, y la dependencia total a los comportamientos suicidas fueron introducidos como variables independientes y la categoría de grandes repetidores como variable dependiente. El modelo final seleccionó la dependencia tota y la edad como las variables estadísticamente significativas en el último paso. En conclusión, nuestro estudio sugiere que los grandes repetidores podrían ser individuos adictos a los comportamientos suicidas. 
The literature provides support for the hypothesis that some major repeaters (individuals with ≥5 lifetime suicide attempts) are addicted to suicidal behavior (SB). This study explores whether major repeaters are addicted to SB or not using 7 criteria: tolerance (Criterion 1), withdrawal (Criterion 2), loss of control (Criterion 3), problems in quitting/cutting down (Criterion 4), much time spent using (Criterion 5), substantial reduction in activities (Criterion 6), and adverse physiological/physical consequences (Criterion 7). Total dependence on SB was indicated by the presence of 3 or more of the 7 criteria in the last 12 months. This cross-sectional study at Puerta de Hierro University Hospital (Madrid, Spain) recruited 118 suicide attempters including 8 major repeaters (7%, 8/118), who were all females. The association between each SB addiction criterion, physiological dependence and total dependence with major repeater status was tested for significance and for effect size with odds ratios (ORs) and their 95% confidence intervals. As hypothesized, major repeaters met significantly higher frequency of criteria for total dependence on SB, OR=62.9 (6.4-615). A backward stepwise logistic regression model was used to provide an OR between major repeater status and total dependence status corrected by confounding variables. Age, panic disorder without agoraphobia, borderline personality disorder, history of psychiatric inpatient admission, and total dependence on SB were introduced as independent variables with major repeater status as the dependent variable. The model selected total dependence and age as the remaining significant variables in the last step. Accordingly, major repeaters appear to be addicted to SB. 

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Publicado

2014-12-01

Número

Vol. 26 Núm. 4 (2014)

Sección

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