各类精神障碍对自杀相关行为的影响

目的了解各类精神障碍对自杀意念、自杀计划、自杀行为的影响。方法在对昆明市精神障碍现况调查的同时,用分层容量比例概率随机抽样法抽取5033名年龄15岁以上的居民进行自杀问题的问卷调查。结果自杀意念、自杀计划、自杀行为的发生率(95%CI)分别为:5.89%(5.24%～6.54%)、1.71%(1.35%～2.06%)、0.96%(0.52%～1.00%)。精神障碍影响自杀相关行为较高的有双相情感障碍、精神分裂症、疼痛障碍、特殊恐怖、酒精依赖等。结论人群中有自杀意念及自杀行为的发生率较高,其中精神障碍是产生自杀相关问题的主要危险因素。     

杭州市青少年自杀问题现况调查

目的:了解青少年自杀问题的现况与相关因素。方法:采用分层整群随机抽样的方法,抽取7335例在校学生,包括初中生2695名、高中生3937名、大学生703名。采用2004年中国疾病预防控制中心编制的《中国青少年健康相关行为调查问卷》,对人口学资料、最近12个月内的自杀问题及相关因素进行调查。结果:本研究样本的自杀意念的检出率为14.3%,自杀计划的检出率为6.9%,自杀行为的检出率为2.1%,多次自杀行为的检出率为1.0%。自杀问题的相关因素分析发现:年级越低(OR=0.92)、求助行为越少(OR=0.62)、母亲受教育程度越高(OR=1.15)、孤独感越多(OR=1.41)、自我伤害行为越多(OR=1.40),自杀意念的检出率越高(均P0.05);求助行为越少(OR=0.67)、孤独感越多(OR=1.21)、自我伤害行为越多(OR=1.49),自杀计划的检出率越高(均P0.05);不安全感(OR=1.16)、失眠(OR=1.33)、抑郁情绪(OR=2.30)、自我伤害行为(OR=2.45)越多,自杀行为的检出率越高(均P0.05);年级越高(OR=1.28),抑郁情绪(OR=3.78)、自我伤害行为越多(OR=2.53),多次自杀行为的检出率越高(均P0.05)。结论:本研究显示杭州市青少年自杀问题的检出率较高,青少年自杀问题可能与孤独、不安全感、抑郁等负面情绪以及来自学校和家庭的压力和缺少社会支持等有关。     

城乡居民对自杀的接受程度及其与自杀意念和行为的关系

目的:了解城乡居民对特殊困境下自杀的接受程度及其与自杀意念、自杀行为的关系.方法:本现况调查以≥18岁人群为研究对象,在北京沈阳2市随机抽取20个居委会共1003例居民,在河北山东2省随机抽取20个村庄共1009例村民.用自制自杀态度、行为及危险因素调查表作为工具,其中对自杀的接受程度分量表(共24个条目,1"绝对不会考虑自杀"-5"肯定考虑自杀"级评分)评估人们在不同困境下考虑自杀的可能性.结果:城市和农村居民对自杀的接受程度得分不同[第25%和75%中位数分别为11.5(3.1～25.0)和13.5(4.2～27.1);P=0.042].城市居民报告曾有过主动自杀意念的比例低于农村居民(7.0% vs.14.9%,P<0.001).总的多因素分析显示:越年轻,受正规教育年限越多,曾有过主动自杀意念,对自杀的接受程度得分越高;分层分析显示:在城市,对自杀的接受程度得分仅与年龄、有主动自杀意念有关(β=-0.09、0.13,P<0.01);在农村,仅与受正规教育年限和有主动自杀意念有关(β=0.17,0.19;P<0.001).结论:人们对自杀的接受程度与既往有无自杀意念相关,但其他相关因素视人群不同而有所不同.     

综合医院医务人员的自杀意念及其相关因素

目的:了解综合医院医务人员自杀意念流行现状和相关因素。方法:本研究采用多阶段分层整群抽样,在山东省调查3426名医务人员,使用自杀意念筛查问题调查了终生和一年自杀意念,采用领悟社会支持量表(PSSS)和Kessler 10量表分别测量社会支持情况和心理痛苦状况。结果:自杀意念终生发生率为9.1%,自杀意念一年发生率为7.0%。博士学历(OR=5.21、6.31,均P<0.001),躯体疾病(OR=1.74、1.66,均P<0.01)和较重的心理痛苦(OR=1.10、1.11,均P<0.001)是终生自杀意念和一年自杀意念的危险因素;男性(OR=0.57、0.55,均P<0.001)、自评执业环境一般(OR=0.72、0.61,均P<0.05)、高社会支持水平(OR=0.98、0.98,均P<0.001)是终生自杀意念和一年自杀意念的保护因素。结论:男性、博士学历、有躯体疾病、自评执业环境一般、心理痛苦状况较重、社会支持水平较低的医务人员更易产生自杀意念。     

住院抑郁症患者自杀相关问题

目的 :探讨住院抑郁症患者自杀相关问题。方法 :调查 2 0 0 0年连续住院抑郁症患者 3 0 9例 ,记录自杀相关问题及相应临床资料。结果 :住院抑郁症患者出现自杀意念、自杀意图、自杀行为的比例相当高。女性病人自杀行为明显多于男性 ,而男性自杀行为的后果较女性更为严重。精神疾病家族史、自杀家族史均与自杀行为关系密切。终身自杀次数与病程、住院次数、总住院时间相关。结论 :住院抑郁症患者存在较多的自杀问题 ,特别对病程长、多次住院、具有精神疾病或自杀家族史者 ,更是自杀预防的重点人群     

初中生应对方式与自杀意念的关系

目的:了解初中生自杀意念的现状,探讨初中生应对方式与自杀意念的关系。方法:从我校每个年级的10个班中,采用分群随机抽样的方法抽取5个班共864人。采用自杀意念自评量表(SIOSS)、中学生应对方式量表进行调查。通过筛选有无自杀意念学生,然后根据不同年级、性别从自杀意念检出率和平均分进行比较,用应对方式各因子的得分与自杀意念量表得分做相关分析。结果:初中生自杀意念的检出率为16.32%。自杀意念检出率女生显著高于男生(χ~2=9.024,P0.01),初二年级学生显著高于初一、初三年级学生(χ~2=10.912,P0.01);在自杀意念的平均得分上女生显著高于男生(t=-5.252,P0.01),初三年级、初二年级学生显著高于初一年级学生(t=8.992,P0.01)。问题解决、积极合理化与自杀意念有显著负相关(r=-0.232,-0.194;P0.01);忍耐、逃避、发泄及幻想否认等指向情绪的应对方式与自杀意念有显著的正相关(r=0.324,0.250,0.296,0.393;P0.01)。结论:初中生应对方式与自杀意念有显著相关。     

浏阳市农村重性抑郁发作患者自杀意念与自杀未遂及影响因素分析

目的: 探讨农村社区重性抑郁发作患者中自杀意念与自杀未遂的阳性率及其影响因素.方法: 采用分层多级随机抽样方法调查浏阳市≥15岁农村常居居民7347人,以定式临床检查(Structured Clinical Interview-I/P,SCID-I/P)为诊断工具进行了抑郁症的筛查及诊断,共发现并确诊重性抑郁发作患者234人,均符合美国精神障碍分类诊断标准(DSM-IV),调查其社会人口学资料及相关危险因素情况.结果: 自杀意念与自杀未遂总阳性率达37.2%,女性高于男性(40.5% vs.31.4%,χ2=10.375,P=0.035).再婚、离异和丧偶者阳性率高于未婚或初婚者(50.0% vs.34.0%,Z=2.577,P=0.010).抑郁症的其他症状表现也与自杀意念和自杀未遂有关.多元logistic回归分析结果提示婚姻状况为再婚、离异或丧偶(OR=1.803,95%CI:1.220～2.532)和无价值感或自罪感症状阳性者(OR=2.056,95%CI:1.139～3.711)自杀意念和自杀未遂发生率较高,兴趣或愉快感缺失症状阳性与自杀意念和自杀未遂呈负相关(OR=0.397,95%CI:0.185～0.851).结论: 重性抑郁发作患者的自杀意念与自杀未遂阳性率较高,性别和婚姻状况对自杀意念与自杀未遂有影响,抑郁症的其他症状表现如无价值感或自罪感和自杀意念和兴趣或愉快感缺失也与自杀未遂有密切关系.     

北京地区40家综合医院住院病人自杀意念和自杀未遂的调查

目的:了解北京地区综合医院住院病人自杀意念、自杀未遂的出现率及其危险因素。方法:采用自制抑郁筛选量表在随机抽取的北京40家各级综合医院中调查了2914例年龄>15岁的住院病人,了解他们自杀意念、自杀未遂发生情况及相关因素,并通过多因素logistic模型发现其危险因素。结果:2914例患者中,187人(6·42%;95%CI为5·58%~7·64%)有过自杀意念,其危险因素排列为:近一年感到绝望的频率高(OR=9·2,95%CI为6·5~12·9)、亲属有过自杀行为(4·3,2·3~8·3)、调查当时有重性抑郁发作(2·7,1·7~4·3)、熟人有过自杀行为(2·0,1·3~2·9)、年龄<55岁(1·7,1·2~2·3)、女性(1·5,1·1~2·1)。2914例患者中,25人(0·86%;95%CI为0·56%~1·26%)有过自杀未遂,其危险因素排列为:目前有重性抑郁发作(OR=5·6,95%CI为2·1~15·1)、亲属有过自杀行为(5·1,1·4~18·9)、近一年感到绝望频率高(4·7,1·9~11·9)、年龄<55岁(3·6,1·4~9·3)、女性(3·6,1·4~9·3)。结论:伴有抑郁症状的综合医院住院病人应视为自杀高危人群,需投入更多的关注。根据其自杀意念、自杀未遂的危险因素,应在综合医院制定和执行有针对性的自杀预防计划。     

大学新生的自杀意念与抑郁情绪、希望特质

目的:探讨大学新生自杀意念的检出率,以及与抑郁情绪、希望特质之间的关系。方法:选取某大学一年级全部新生4372名,采用症状自评量表(SCL-90)第15项评估自杀意念,采用抑郁自评量表(SDS)、希望量表(DHS)评估抑郁症状和希望特质。收回有效问卷4211份。结果:大学新生自杀意念发生率为4.5%(189/4211),女生自杀意念率高于男生(6.7%vs.3.7%,P0.05)。有自杀意念学生的SDS得分高于无自杀意念者[(42.0±7.3)vs.(34.2±6.3),P0.05],DHS得分低于无自杀意念者[(43.6±8.8)vs.(49.8±8.1),P0.05]。SDS得分越高,越容易产生自杀意念(OR=1.15,P0.01);而DHS得分越高,自杀意念产生的可能性越小(OR=0.95,P0.05)。结论:本研究发现提示大学新生自杀意念的产生可能与抑郁情绪相关,而希望特质可能是保护因素,对有自杀意念的大学生应重视抑郁情绪的评估。     

高中生自杀态度的特征及其与自杀意念

目的研究高中生自杀态度的基本特点及其与自杀意念的关系。方法选用青少年自杀意念量表(PANSI)和自杀态度量表,对河南省1143名高中生进行问卷调查。结果 11143名高中生对自杀行为性质的认识(t=14.004)、对自杀者家属的态度(t=12.312)、对安乐死的态度(t=14.552)在家庭居住地上存在显著差异(P<0.05);2相关分析表明,自杀意念与自杀行为性质的认识、对自杀者家属的态度、对安乐死的态度呈负相关,其中对自杀者家属的态度负相关程度最高(r=-0.082,P<0.01);3线性回归分析显示,对自杀行为性质的认识、对自杀者的态度、对安乐死的态度3个因子能联合预测自杀意念的变异量6.1%的变异性。就个别变量的解释来看,以"对自杀行为性质的认识"的预测力最佳。结论高中生对于自杀态度及自杀意念在不同性别、不同家庭居住地差异上有统计学意义。自杀态度持肯定认同者,其自杀意念越强烈。     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Intestinal helminthiasis in school children in Haiti in 2002

A survey on intestinal helminths in school children was conducted in Haiti in 2002. This first nationwide study involving the entire country was stratified by department according to urban and rural zones using the cluster method. Focusing on elementary school children (n=5792; age range 3 to 20 years), it involved 26 urban and 49 rural schools randomly selected. Stools were preserved in formalin and examined by the Ritchie technique. Thirty-four per cent of stools (1981/5792) tested positive for intestinal helminths with the following parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis (0.2%). The helminth prevalence was higher in rural (38.4%) compared to urban areas (30%). There was no significant difference in prevalence by sex and age. The importance of geohelminths changed from one department to another with the highest prevalence found in the Southern department of Grande Anse (73.7%) and the lowest prevalence in the Center department (20.6%). Five out of the country's nine departments had a similar prevalence varying from 25.5% to 28.2%. Intestinal helminthic polyparasitism was observed in a percentage of infested school children comprise between 3.4% and 28.6% according in relation to the geographical area. A program to fight against geohelminths in school children should be initiated as a public health priority. Albendazole is the drug of choice. Frequency of drug distribution should be based on the prevalence of geohelminths in each department.     

Changes in the hypothalamic nuclei in in experimental allergy

Summary In rabbits subjected to prolonged sensitization and in which the Arthus phenomenon was induced there was a marked reaction of the hypothalamic nuclei. Staining by Gomori's method indicated a cellular swelling, loss of granules, and protoplasmic vacuolization in the supraoptic nucleus. There was a considerable increase in the size of the cross-sectional area of the cells. The same effects were much less well shown in the paraventricular nucleus. These results show that marked signs of increased neurosecretion developed in the animals at the height of the Arthus phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten Éksperimental'noi biologii i Meditsiny, Vol. 55, No. 4, pp. 110–113, April, 1963.     

Experience in adult population in dengue outbreak in Delhi

A dengue outbreak has recently hit the Indian capital. We studied the clinical profile of adult patients. Five hundred and sixty patients of dengue infection were admitted in a specially created ward according to the criteria laid down by WHO. Haematemesis (28.28%), epistaxis (26.78%) and malena (14.28%) were some of the common presentations. Similarly lymphadenopathy, especially cervical (30.89%), palatal rashes (26.96%) and hepatomegaly (23.75%) were the most commonly encountered findings on physical examination. Most of the cases were of dengue fever with haemorrhage and only 2.5% cases were classified under dengue haemorrhagic fever or dengue shock syndrome. The average hospital stay was 3.4 days but only 9.8 hours in the eleven patients who died, suggesting their late arrival in preterminal situation giving little time for resuscitation. Thrombocytopenia was not a feature and only 12.85% patients had platelet count less than 70,000/cmm. Most of the patients who were admitted with thrombocytopenia, showed normalization in their platelet counts in next few days. Serological examination demonstrated evidence of recent dengue infection in 41.17% patients. Few patients required blood or platelet concentrate transfusion. Eleven patients died, three due to DIC, one of intracranial haemorrhage and seven due to massive gastric haemorrhage. Rest of the patients recovered completely. Thus we can conclude that recent outbreak in Delhi was of dengue fever with haemorrhage and mortality was very low in patients who came early to the hospital.     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.