Missing data by variable in order of assessment.

Persons who suffer from unbearable psychiatric illness and a persistent death wish (chronic suicidality and/or a psychiatric euthanasia request) are an understudied subgroup of persons with Severe and Persistent Mental Illness (SPMI). They receive tailored care in Reakiro, a Belgian drop-in, care and expertise centre, where persons can enrol in existential counselling or peer support groups. Suicidology and psychiatric euthanasia literature identify several risk and protective factors that play a central role in the process of death wishes: meaning, hope, empowerment, suicidal ideation, existential anxiety, and psychosocial dysfunctioning. The aim of the study is to describe these central factors in this subgroup of persons attending Reakiro and compare them with other patient samples worldwide in order to position this subgroup in terms of severity of suffering. Another aim was to evaluate how the Reakiro care was experienced by the users. The Beck Scale for Suicide Ideation (M = 21.78, SD = 8.48), Netherlands Empowerment List (M = 113.39, SD = 20.42), Herth Hope Index (M = 24.15; SD = 5.40), Meaning In Life Measurement (M = 5.39, SD = 1.50), Existential Concerns Questionnaire (M = 62.13, SD = 12.11), and Outcome Questionnaire-45 (M = 98.93, SD = 20.50) showed very high suicidal ideation and severe suffering across all domains. The Reakiro sample scored almost exclusively worse on all factors compared with 20 samples worldwide. Users perceived Reakiro care as helpful, with individual counseling services as most helpful. Reakiro care seems to be a promising model appealing to this subgroup of persons with SPMI and a persistent death wish. These results should be interpreted with caution, as the cross-sectional design has several limitations. Replication or falsification with forthcoming longitudinal data is needed. Clinical implications of the results are discussed.

患有难以忍受的精神疾病且存在持续性求死意愿（慢性自杀倾向和/或精神性安乐死请求）的人群，是严重且持续性精神疾病（Severe and Persistent Mental Illness, SPMI）患者中尚未得到充分研究的亚群体。该人群可在比利时一家提供随到随护、专业护理与咨询服务的日间中心Reakiro接受定制化照护，并报名参加存在主义心理咨询或同伴支持小组。自杀学与精神性安乐死相关文献已明确，在求死意愿的形成过程中，若干核心风险与保护因素发挥着关键作用，包括生命意义感、希望感、赋权、自杀意念（suicidal ideation）、存在主义焦虑（existential anxiety）以及社会心理功能失调（psychosocial dysfunctioning）。本研究旨在描述该Reakiro就诊亚群体的上述核心因素，并与全球其他患者队列进行对比，以明确该亚群体的痛苦严重程度层级；另一项研究目标为评估服务使用者对Reakiro照护方案的体验感受。研究对象在贝克自杀意念量表（Beck Scale for Suicide Ideation）中的得分平均值为21.78，标准差为8.48；荷兰赋权量表（Netherlands Empowerment List）得分为113.39±20.42；赫特希望量表（Herth Hope Index）得分为24.15±5.40；生命意义感测量量表（Meaning In Life Measurement）得分为5.39±1.50；存在主义担忧问卷（Existential Concerns Questionnaire）得分为62.13±12.11；结果问卷-45（Outcome Questionnaire-45）得分为98.93±20.50，结果显示该群体自杀意念水平极高，且各维度均存在严重痛苦体验。与全球20个患者队列相比，Reakiro队列在所有因素上的得分几乎均更差，提示其痛苦程度更高。服务使用者普遍认为Reakiro的照护方案具有帮助性，其中个体心理咨询服务的帮助效果最佳。Reakiro照护模式似乎是一种颇具前景的方案，能够吸引该类存在严重且持续性精神疾病、伴有持续性求死意愿的亚群体。由于本研究采用横断面设计，存在若干局限性，因此对研究结果的解读需谨慎；未来需通过纵向研究数据对本研究结果进行重复验证或证伪。本文还对研究结果的临床应用价值进行了探讨。