艾滋病病人自杀意念的心理、社会影响因素研究

目的了解艾滋病人自杀意念的发生率，探讨艾滋病人产生自杀意念的心理、社会因素。方法选择3个艾滋病项目县中能随访到的175名艾滋病人作为研究对象。用自制的艾滋病人心理健康状况与相关生活经历调查表、抑郁自评量表（SDS）、家庭功能量表（APGAR）、生命质量量表对目标人群进行凋查。结果过去曾有过自杀行为的有12人（占6．9％），其中有6人（50．0％）自杀的主要目的是解脱痛苦；有62人（35．4％）曾想过自杀或故意伤害自己；logistic逐步回归分析结果表明，生活质量和抑郁程度与是否产生自杀行为间差异有统计学意义（P〈0．05）；自杀意念的产生与性别、配偶感染HIV的情况、家庭功能和抑郁程度因素有关。结论艾滋病人自杀意念的产生是多种社会心理因素综合作用的结果，改善艾滋病人抑郁程度和家庭功能状况是降低艾滋病人自杀意念率和自杀行为的一个重要途径。     

性病艾滋病恐惧症110例心理咨询情况

目的:了解性病艾滋病恐惧症形成原因,寻找预防控制的措施.方法:对110例性病艾滋病恐惧症患者的临床症状和全身不适进行分析.结果:绝大多数患者都有不洁性交史,占82%,发病与患者的文化程度、心理因素和医学误导有关.结论:目前应加强对性病艾滋病恐惧症的预防、加强对性病艾滋病知识的宣传教育和心理疏导.     

河南某高校大学生自杀态度心理因素分析

自杀态度是个体对自杀行为的看法和认知[1].也有学者把自杀态度定义为“个体对自杀行为、自杀者等所持有的一种具有持久性与一致性的倾向”[2].有研究表明,自杀率的高低与人群对自杀的态度密切相关[3].石文娟等[4]研究发现,对自杀行为持赞成、理解态度者自杀意念的危险度是持反对态度者的8.28倍.研究大学生的自杀态度及心理因素对自杀态度的影响,对于在大学生中进行有效的具有针对性的自杀预防具有重要意义.     

杭州市中学生自杀态度分析

目的 了解杭州市中学生对自杀的态度,为中学生自杀的预防和治疗提供依据.方法 在杭州市10所中学随机抽取了1250名中学生作为调查对象,同时在杭州市10个社区随机选取980名成年人作为对照,采用自杀态度问卷进行调查.结果 17.6%的中学生对自杀行为持肯定或理解的态度,而且随着年龄逐渐增加,对自杀行为的肯定或理解程度也随之增加;只有13.8%的成年人肯定或理解自杀行为;中学生对自杀者及自杀者家属的肯定或理解程度也远远高于成年人.结论 青少年的高自杀率与其对自杀持肯定或理解的态度有一定的关系,提示预防青少年自杀时要重视态度的改变.     

自杀风险评估分层护理干预对新入院抑郁症患者自杀行为的影响观察

目的探讨自杀风险评估分层护理干预对新入院抑郁症患者自杀行为影响。方法选取2017年11月至2018年8月我院的新入院抑郁症患者80例,随机分为干预组(自杀风险评估分层护理干预, 40例)和常规组(基础护理, 40例),比较两组患者干预前及干预1个月后的自杀态度评分、自杀行为及满意度。结果干预1个月后,两组患者的自杀态度、自杀行为认识、安乐死态度、自杀对家属态度评分均显著升高,且干预组的上述评分均显著高于常规组(P均<0.05)。干预组的自杀行为发生率为7.50%,低于常规组的30.00%(P <0.05)。干预组的满意度为97.50%,高于常规组的77.50%(P <0.05)。结论自杀风险评估分层护理干预在新入院抑郁症患者中实施,能够改善患者自杀态度和自杀行为,提高患者的满意度。     

高校后勤员工自杀意念及其影响因素分析

自杀为中国意外伤害死亡的重要死因之一,世界卫生组织也将其列为我国公共卫生第4位重要问题[1].自杀意念是采取自杀行为的心理基础,是导致自杀死亡的强危险因素,也是自杀行为干预的关键时期.本研究于2010年7月调查浙江省杭州市某高校1045名后勤员工的心理健康状况,分析了其自杀意念的特点,探讨其与心理健康和工作满意度的关系,拟为高校后勤员工自杀危机的早期干预提供参考依据.     

广州市艾滋病阳性者自杀行为及社会心理因素分析

  目的  了解广州市艾滋病病毒阳性者自杀意念和自杀行为现状,探讨其影响因素,分析社会心理因素与之的相关性。  方法  在广州市六区抽取HIV阳性成人患者进行横断面调查,收集社会人口学特征、HIV感染情况、自杀意念、自杀行为、社会心理因素等信息,以自杀意念、自杀行为为因变量,进行单因素和多因素Logistic回归分析。  结果  464名调查对象中,5.2%和17.4%分别有过自杀行为与自杀意念。其中,感染途径、抑郁、焦虑、社会歧视、自我歧视与自杀行为的发生有关（均有P < 0.05）;年龄、健康状况、配偶感染、抑郁、焦虑、社会支持、社会歧视、自我歧视与自杀意念的发生有关（均有P < 0.05）。多因素logistic回归分析模型显示抑郁、自我歧视与自杀行为发生有关（均有P < 0.05）,抑郁、社会歧视与自杀意念发生有关（均有P < 0.05）。  结论  广州市HIV阳性成人患者的自杀意念与行为发生率较高,应在HIV阳性者中针对性地开展抑郁、社会歧视、自我歧视相关的心理咨询、风险评估并尽早干预治疗。     

上高县自杀原因分析

自杀和自伤在我国人群的意外伤害中为第一位死因.农村地区人群的自杀死亡率几乎是城市地区的4倍.因此,了解江西省上高县人群自杀行为发生的主要原因和方式及人们对自杀行为的认识和态度,以为预防自杀行为提供依据.     

抑郁症患者与精神分裂症患者自杀行为的比较与分析

目的比较抑郁症与精神分裂症住院患者自杀行为的发生比率,临床特征及自杀死亡率的差异。方法是采用病史询问,精神检查和方式评定的方法,确定抑郁症34例,精神分裂症64例为研究对象,并在3年后追踪调查其自杀死亡的情况。结果住院抑郁发作的自杀率为89.5%,自杀未遂者为57.9%,精神分裂症自杀行为的发生率为33%,其中自杀未遂者为12.9%,影响抑郁症自杀行为的影响因素除情绪障碍外有8%～11%的患者伴有妄想症状,影响精神分裂症的自杀的主要因素为幻觉妄想。抑郁症与精神分裂症伴有自杀行为的追踪病例中病程在6年内自杀死亡的比例分别为5%～6%和2.9%。结论抑郁症的自杀和精神分裂症的自杀行为是精神科临床危机干预的重要内容。     

9例晚期癌症患者自杀原因分析及护理对策

目的分析晚期癌症患者自杀的原因及护理对策。方法回顾性分析9例有过自杀行为的晚期癌症患者的基本情况。结果患者自杀的原因有心理、生理、社会、经济压力等因素。结论癌症患者晚期易发生自杀,应对癌症患者及时进行危险评估和心理干预,加强病房管理,提供良好的社会支持,减少患者产生自杀意念和自杀行为。     

Assessment of suicidal behaviour in general practice

AIM: To assess the prevalence of suicidal behavior (wish to die, suicidal thoughts, suicide attempts) and to determine the characteristics of suicide attempters in primary care, including screening for major mental disorders. METHOD: A Hungarian urban general practitioner's district with 1248 inhabitants was screened for suicidal behavior as well as for major mental disorders. All the patients (n=382) who visited their general practitioner within a two-week period were asked to participate. 277 patients completed the Prime-MD questionnaire, an easy-to-use diagnostic instrument developed for general practitioners to recognize the most common psychiatric disorders, like depressive (major depressive disorder, minor depressive disorder), anxiety (panic disorder, generalized anxiety disorder), somatoform, eating and alcohol related disorders. Detailed data about suicidal thoughts and attempts were also collected by the structured questions of MINI-Plus diagnostic interview. RESULTS: Prevalence of suicide attempts in primary care was 2.9%. 9% of the patients had either suicidal thoughts or suicide attempts in the previous month. Suicidal patients were more ready to use psychotropic drugs, they assessed their health status more poorly, and had more mental symptoms than the control group (non-suicidal patients). 60% of suicidal patients and 11.5% of the investigated population had a current depressive episode. Beside depressive symptoms, anxiety disorders and alcohol problems were also more common among suicidal patients. The rate of previous psychiatric treatments was also higher in suicidal patients, who generally visited their general practitioners less frequently than non-suicidal patients. According to multivariate logistic regression, suicidal patients are more ready to take antidepressants, they tend to have more previous psychiatric treatments and suicidal attempts, and they visit their general practitioners less frequently and have a current depressive episode. CONCLUSION: Suicidal behavior and mental disorders are frequent in primary care. Since almost every tenth patient visiting their general practitioner has suicidal thoughts or depressive or anxiety disorder, the recognition of suicide risk and mental disorders is very important in primary care. As for preventing suicides, the diagnosing and treating of mental disorders -especially affective disorders- are very important for general practitioners. In addition to pharmacotherapy, psychotherapies are also important in treating patients in crisis situations, or with suicidal thoughts or depressive disorder. The modified Prime-MD questionnaire can be an effective, easy-to-use method in the hand of the general practitioners to identify suicidal risk and to recognize the most common mental disorders in the average population.     

深圳、云南两地中学生艾滋病与危险行为的健康教育需求的研究

1998年5月采用分层整群抽样方法,对深圳、云南两地中学生进行抽样问卷调查。结果表明：（1）中学生对有关艾滋病的基本知识回答正确率为26．8％－75．1％,学生艾滋病及相关知识得分随年级增长而增加：男生平均得分高于女性;深圳学生平均得分高于云南生;（2）学生尚无足够知识以保护自己免受HIV／AIDS的侵袭,并且在学生中普遍存在对AIDS的恐惧心理和对AIDS病人的歧视态度,仅10．1％的学生表示愿意与患AIDS或感染HIV的同学同班学习;（3）中学生中存在着多种危险行为。调查提示,在中学生中开展有针对性的健康教育,促进危险行为的转化是非常迫切和重要的。     

Desire to die in terminally ill people: a framework for assessment and intervention

"Desire-to-die" statements made by people with terminal illness may be expressions of depression, suicidal intent, or coping. Careful evaluation can help the social worker understand the meaning of a particular patient's statement. The framework presented in this article suggests that all patients expressing a wish for death be assessed for both depression and suicide risk. This assessment can identify those patients who are depressed or suicidal, as well as those using these statements as a way of coping or as an indication of a rational choice for suicide. Differentiating among patients' meanings in this way leads to appropriate interventions.     

Adolescent Alcohol Use,Suicidal Ideation,and Suicide Attempts

PurposeTo examine the association between self-reported alcohol use and suicide attempts among adolescents who did and did not report suicidal ideation during the past year.MethodsScreening data from 31,953 students attending schools in the United States that implemented the Signs of Suicide (SOS) program in 2001–2002 were used in this analysis. Two types of alcohol use were investigated: heavy episodic drinking, and drinking while down. Self-reported suicide attempts were regressed on suicidal ideation and both measures of alcohol use, controlling for participants’ levels of depressive symptoms, and demographic characteristics.ResultsLogistic regression analyses indicated that both drinking while down and heavy episodic drinking were significantly associated with self-reported suicide attempts. Analyses examining the conditional association of alcohol use and suicidal ideation with self-reported suicide attempts revealed that drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year. Heavy episodic drinking was associated with increased risk of suicide attempt equally among those who did and did not report suicidal ideation.ConclusionsThis study identified the use of alcohol while sad or depressed as a marker for suicidal behavior in adolescents who did not report ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk. Findings from this study should provide further impetus for alcohol screening among clinicians beyond that motivated by concerns about alcohol and substance use.     

The association between alcohol misuse and suicidal behaviour

AIMS: Despite recent small reductions in overall suicide rates, rates among those aged 25-44 have remained high. The aim of this paper was to examine the evidence for a link between alcohol misuse/consumption and suicidal behaviour, explore the reasons for this association, and consider the implications for reducing rates of suicidal behaviour. METHODS: A medline search was performed to find relevant research evidence. RESULTS: There is evidence to suggest alcohol misuse predisposes to suicidal behaviour through its depressogenic effects and promotion of adverse life events, and both behaviours may share a common genetic predisposition. Acute alcohol use can also precipitate suicidal behaviours through induction of negative affect and impairment of problem-solving skills, as well as aggravation of impulsive personality traits, possibly through effects on serotonergic neurotransmission. CONCLUSIONS: Effective interventions for problem drinking may help reduce suicide rates. At a public health level, reducing overall alcohol consumption may be beneficial, and the measures shown to be most effective in this regard are those that aim to restrict availability of alcohol.     

Physical illness and suicidal behavior. Review of results at the Pécs Center of the WHO/EURO Multicenter Study of Parasuicide

The authors examined the relation of physical illness, suicidal behaviour and help-seeking patterns among suicide attempters within the framework of the WHO/EURO Multicentre Study on Parasuicide. Until now 700 monitored suicidal events have been collected; 101 structured interviews and 50 follow-up cases have been conducted in this three years period. Physical and mental problems proved to be very frequent among suicide attempters and many of them took somatic and psychiatric drugs. It was shown that patients with acute or chronic physical and mental illness more often had been in contact with GPs. Authors pointed out that in addition to mental problems the somatic diseases are significant risk factors in suicidal behaviour. In many cases these factors were not recognised and thus patients could not get help. Authors emphasised the importance of training GPs, since complex diagnostic and therapeutic approach is essential to prevent suicide.     

Suicidality

Prevention of suicidal behaviour remains difficult, despite increasing knowledge of its determinants. Health service efforts hardly affect suicide rates. Recent shifts in the epidemiology of suicidal behaviour are rising rates among the young and increasing use of violent methods; these can be linked to emerging aetiological insights. Early stages of the suicidal process often manifest themselves at an early age, as emotional and behavioural instability. Epidemiological evidence suggests that the suicidal process increasingly concentrates itself in a vulnerable minority in whom it progresses rapidly to a phase of relative unresponsiveness to environmental influences including preventive efforts. Thus, prevention should focus not only on persons in the later stages of the suicidal process like psychiatric patients, but especially on individuals who, as youngsters, show signs of entering its very first stages. Since high suicide risk implies high risk of other adverse health outcomes as well, this should, in time, yield health gains in more domains than suicide reduction only.     

大学生对自杀行为的认知、态度及其影响因素的分析

目的了解大学生对自杀行为的态度、看法及其影响因素,为在高校开展自杀预防与干预工作提供科学依据。方法采用分层整群随机抽样方法,应用贝克抑郁量表（BDI）和自杀态度与知识量表,对暨南大学的本科生进行问卷调查。结果 30.7%的大学生认为自杀未遂与自杀死亡程度是相似的,认为自杀是不可预防、不可以自我控制的分别占21.5%和15.5%,45.3%的大学生歧视自杀。有自杀意念的学生比无自杀意念的更倾向于认为自杀未遂与自杀死亡程度相似、自杀不可预防、自杀无法自我控制;女生比男生更认同自杀是可以自我控制的;经济/管理类学生、来自香港、澳门、台湾的学生、家庭经济好的学生更加歧视自杀;个人每月生活费、家庭对本人读书的负担、学习成绩满意度是影响大学生自杀看法与态度的因素。结论应加强心理健康的宣传教育,提高大学生对自杀行为的正确认识,促进大学生身心健康发展,预防自杀的发生。     

广州市高校大学生自杀意念发生的危险因素

目的 了解广州市大学生自杀意念的发生情况及危险因素，为预防大学生自杀提供依据。方法 采用统一调查表，以随机抽样的方法调查广州市6所高校的大学生2143名，并通过单因素和多因素Logistic回归模型筛选出自杀意念的危险因素。结果 自杀意念的发生率为18．53％。多因素Logistic回归分析揭示，自杀意念发生的主要危险因素有曾患精神分裂症或抑郁症、服用成瘾性物质、以往有过自我伤害行为、喜欢从阴暗面看问题等。结论 自杀意念在大学生中较为常见，应加强其心理素质教育，防止自杀行为的发生。     

AIDS患者感染结果告知、歧视知觉、社会支持与自杀意念的关系

  目的  分析AIDS患者的歧视知觉和自杀意念,以及歧视知觉、自杀意念和HIV感染结果告知及社会支持之间的关系。  方法  采用一般特征调查表、领悟社会支持量表(perceived social support scale, PSSS)、歧视知觉量表(self-stigma scale, SSS)和贝克自杀意念量表中文版(Beck scale for suicide ideation-Chinese version, BSI-CV)对某省会城市1 276名AIDS患者进行匿名调查。  结果  54.2%(692/1 276)的样本报告自己在过去1周或抑郁最严重时有过自杀意念。多因素分析显示,控制其他因素,歧视知觉(OR=0.57, 95% CI: 0.45~0.72, P < 0.001)与社会支持呈负相关,感染结果告知(OR=1.47, 95% CI: 1.12~1.92, P=0.005)与社会支持呈正相关。歧视知觉(OR=5.53, 95% CI: 4.21~7.27, P < 0.001)与自杀意念呈正相关,社会支持(OR=0.58, 95% CI: 0.45~0.76, P < 0.001)与自杀意念呈负相关。感染结果告知在患者的歧视知觉与社会支持间起部分中介作用(中介效应占总效应比例为29.0%);社会支持在患者的歧视知觉与自杀意念间起部分中介作用(中介效应占总效应比例为17.5%)。  结论  AIDS患者当中有自杀意念的比例较高。低歧视知觉、将感染结果告知家人、朋友及固定伴侣的患者领悟到的社会支持更高。高歧视知觉、低社会支持的患者自杀意念较强。感染结果告知在患者的歧视知觉与社会支持间起部分中介作用,而社会支持则在患者的歧视知觉与自杀意念间起部分中介作用。