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1.
目的了解有严重躯体疾病的老年自杀死亡者的特征并比较有无精神障碍者特征的异同。方法由精神科医师运用心理解剖方法对全国23个疾病监测点上报的≥55岁的304例自杀案例的家属和周围知情人进行调查,分析其中178例(58.6%)报告自杀死亡前1年内有严重躯体疾病者的自杀特征。结果178例自杀死亡者中,女性占41.6%;79.2%居住在乡村;58.4%从未上过学;38.8%丧偶;25.8%有自杀未遂既往史;10.7%一级血缘亲属有自杀行为;43.3%服农药或鼠药自杀,32.6%上吊;68.0%自杀当时有精神障碍,主要是重性抑郁障碍;仅5.1%自杀当时有人在场。有、无精神障碍者在社会人口经济学特征、有无自杀未遂史和自杀行为家族史、负性生活事件导致的慢性心理压力和急性应激强度以及自杀前一个月的生命质量等方面的差异无统计学意义(P均大于0.05)。结论有严重躯体疾病老年人自杀死亡最常见的两种方式是服毒和上吊,2/3有精神障碍,但有无精神障碍者的自杀相关特征无明显不同。  相似文献   

2.
目的探讨自杀未遂者精神障碍和自杀意念强度特征,为自杀未遂的心理危机干预策略提供参考。方法在沈阳市4所三级综合医院急诊室同一时段内收集到资料完整的239例自杀未遂者,以贝克自杀意念量表(BSS)评估自杀意念及其强度,以汉密尔顿抑郁量表(HAMD)评定自杀前1周的抑郁程度。精神障碍诊断标准按照美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)。结果①自杀未遂者总的精神障碍发生率为69.46%(166/239),前3位依次为:心境障碍47.70%(114/239),焦虑障碍38.91%(93/239),精神病性障碍8.37%(20/239);②有自杀意念的自杀未遂组总的精神障碍发生率为84.34%(140/166),其中心境障碍和焦虑障碍的发生率分别为61.45%(102/166)和48.19%(80/166),均明显高于从无自杀意念组(P0.01);HAMD总分以及其中焦虑/躯体化、体重减轻、认知障碍、日夜变化、迟缓、睡眠障碍、绝望感等因子中的项目得分明显高于从无自杀意念组(P0.01);③在有自杀意念的自杀未遂患者中,有精神障碍组BSS中13个条目的自杀意念强度较无精神障碍组高(经秩和检验,P0.05)。结论自杀未遂者中以精神障碍患者居多,且有自杀意念并伴精神障碍的自杀未遂者其自杀意念严重程度更重。  相似文献   

3.
冲动性与非冲动性自杀未遂的比较   总被引:24,自引:5,他引:19  
目的 自杀未遂是我国重要的公共卫生问题,但缺乏针对性的、有效的干预措施。本研究通过比较冲动性与非冲动性自杀未遂的特征,为制定相应的预防措施奠定基础。方法 对4所市县级综合医院的306例病情较重的自杀未遂病人用自制调查表进行调查。按其自杀前考虑自杀时间的长短人为地分为冲动性(≤2小时,164例)和非冲动性(>2小时,142例)两组,并对两组进行比较。结果 两组在许多方面有显著差异。用非条件Logistic回归分析控制不同因素之间的相互影响后,发现在自杀未遂者中,自杀前2周抑郁程度越轻、自杀意图强度越低,有急性(≤1月)负性生活事件、自杀前1个月生命质量越高、居住在乡村、越年轻越易发生冲动性自杀行为;而性别和其他因素与冲动性自杀行为的发生无关。结论 冲动性与非冲动性自杀未遂的特征明显不同,对这两种不同的自杀未遂人群是否应采取不同的预防及干预措施是目前迫切需要解决的问题。  相似文献   

4.
背景中国农村的自杀率是城市自杀率的2~3倍,但造成城乡自杀率之巨大差异的原因并不清楚。目的评估国内农村严重自杀未遂者的特征及危险因素。方法精神科医生采用结构式问卷对山东郓城县人民医院急诊室收治的297例严重自杀未遂者(至少在医院6小时者)及其陪伴的家属分别进行访谈。该问卷内容详尽,完成问卷需要2~3h。对照组选取同一居住地中年龄、性别与自杀未遂组相匹配的、既往无自杀未遂史的居民及其同住家庭成员,分别进行同样的结构式访谈。使用Cox回归模型来识别自杀未遂的危险因素。结果 297例自杀未遂者中,74%为女性,78%是农民,平均(标准差)年龄为33.2(14.6),平均受教育年限为4.8(3.1)年,80%为口服农药自杀,57%的自杀未遂者报告在采取自杀行动之前考虑自杀只有或不足5分钟,76%的自杀意图量表中计划分量表得分不足50分(0~100分),11%有过自杀未遂史,只有38%存在符合DSM-IV诊断标准的精神障碍。在控制性别、年龄、居住地以及之前的自杀未遂史(在配对分析中控制该变量)后,通过多因素分析,自杀未遂的危险因素包括:受教育水平低、与有过自杀行为的人交往、之前1年中至少有4次负性生活事件、之前1个月中生活质量低且家庭不够和睦、之前2周内的抑郁症状得分高以及冲动性和攻击性高(最后一项仅在小样本中进行评估)。结论我国农村严重自杀未遂者多数不符合精神障碍的诊断标准,冲动性和攻击性高、自杀意图并不强烈,多采用口服农药的方式。这些特点与高收入发达国家的特点不同,因而需要采取不同的方法来预防自杀行为。这些方法应更多的关注如何降低获取农药的便利性,并教育冲动性个体如何自我调整情绪和行为,而不是过度地关注精神障碍的识别和治疗。  相似文献   

5.
目的探讨农村未遂自杀者再自杀意念的发生率及其相关因素。方法以乡镇卫生院近2年的抢救记录为调查线索,共完成74例自杀未遂者的调查,对其再自杀意念进行评定,并用SDS和FES对其抑郁症状和家庭环境进行评估,收集其一般资料。结果74例自杀未遂者中有48例(64.86%)有不同程度的再自杀意念,48例有再自杀意念者的SDS得分(42.42±7.64)明显高于26例无再自杀意念者(33.58±9.52)(t=4.35,P<0.001),有再自杀意念组的家庭亲密度、成功性、文化性、娱乐性和组织性均较无再自杀意念组差,家庭矛盾性较对照组突出。多元逐步回归分析显示,影响自杀未遂者再自杀意念的主要危险因素为:家庭成功性、SDS总分和家庭矛盾性。结论64.86%的自杀未遂者在其后的一段时期内仍存在不同程度的再自杀意念,而且再自杀意念主要与患者的家庭环境和患者的抑郁症状有关。  相似文献   

6.
农村地区有、无精神障碍自杀未遂者及其自杀特征的比较   总被引:11,自引:0,他引:11  
目的 比较农村地区有、无精神障碍自杀未遂者的特征。方法 以 1998年 8月至 2 0 0 0年 8月四所县 (市 )级综合医院急诊室中自杀未遂者 (共 5 78例 )为研究对象 ,有 32 6例完成自制问卷调查 ;其中 12 9例 ( 39 6 % )符合美国精神障碍诊断与统计手册第 4版中精神障碍的诊断标准 (有精神障碍组 ) ,197例 ( 6 0 4 % )无精神障碍 ,比较两组的特征。结果  ( 1)两组社会人口学各变量的差异均无显著性 (P >0 0 5 ) ;有精神障碍组既往有自杀未遂史的比例 ( 2 7 9% )高于无精神障碍组 ( 8 2 % ) ,而口服农药 ( 75 2 % )和冲动性自杀的比例 ( 2 7 3% )低于无精神障碍组 (分别为 88 3%和 6 9 4 % ) ;( 2 )有精神障碍组的自杀意图强、慢性负性生活事件 (对心理影响≥ 1年 )多 ,急性应激强度小 (均P <0 0 0 1)。结论 有、无精神障碍自杀未遂者及自杀特征明显不同 ,对两种自杀人群应采取不同的干预措施。  相似文献   

7.
15~24岁人群自杀特征及危险因素的病例对照研究   总被引:12,自引:0,他引:12  
目的了解全国15~24岁自杀死亡者的特征,并通过与其他伤害死亡案例的比较了解青年自杀的危险因素。方法由精神科医师运用心理解剖方法对全国有地理代表性的23个疾病监测点上报的15~24岁的88例自杀案例(自杀组)和76例其他伤害死亡案例(对照组)的家属和周围知情人进行深入调查。结果(1)自杀组的平均受教育年限为(6.2±3.2)年,59%为女性,88%居住在乡村,82%服毒或服药自杀,26%为现婚,76%自杀前一直在工作或学习,26%有自杀未遂既往史,14%有血缘关系的人曾有自杀行为,31%朋友或熟人有过自杀行为,50%自杀当时有精神疾病,18%曾因心理问题寻求过帮助。(2)有既往自杀未遂史(经单因素分析)、自杀前2周有抑郁症状、自杀当时急性应激强度大和自杀前1个月生命质量低(后3项经多因素logistic回归分析)是自杀的危险因素。结论15~24岁自杀死亡者中50%有精神疾病,仅极少数自杀死亡者曾因心理问题寻求帮助。自杀未遂既往史、近2周有抑郁症状、经历急性负性生活事件和近1个月生命质量低为青年自杀死亡的主要危险因素。  相似文献   

8.
酒中毒自杀未遂者的临床分析   总被引:1,自引:1,他引:0  
对嗜酒自杀身亡者的特征已有较多研究 [1 ] ,试图找出预防自杀的方法。我们从临床医学的角度对嗜酒者自杀未遂者进行初步分析 ,报告如下。1 临床资料为 1995~ 1997年在我院住院患者 ,符合 CCMD- 2 - R酒精所致精神障碍诊断标准 ,共 87例 (2 .1% ) ,均为男性。根据有无自杀观念和行为分为自杀组 (2 1例 )及非自杀组 (6 6例 ) ,对两组资料进行比较分析。自杀组 2 1例 ,发病年龄 2 6~ 6 3岁 ,平均 (45 .1± 5 .7)岁 ;非自杀组 6 6例 ,发病年龄 2 3~ 6 6岁 ,平均 (42 .4±6 .2 )岁。两组年龄及职业、文化、婚姻、病前性格等均无显著差异 (…  相似文献   

9.
目的 了解自杀未遂者再自杀情况及其影响因素.方法 对115例住院自杀未遂者出院后18个月、3年、5年、6年进行4次随访.结果 115例自杀未遂者中6年内21例再次出现自杀行为(18.3%),其中自杀死亡5例(4.3%).21例再次自杀者平均年龄(44.2±14.3)岁,13例有精神障碍(61.9%),8例既往(入院前)有自杀未遂史(38.1%),与94例无再次自杀行为者比较,两组在年龄(t=3.42)、精神疾病(χ2=11.20)、既往自杀未遂史(χ2=24.18) 方面的差异有统计学意义(均P<0.05).Logistic回归分析,仅既往自杀未遂史(P<0.01,OR=10.21,β=2.32)进入回归方程.115例自杀未遂人群总的随访时间为723.55人年,以此推算6年内该组自杀未遂者群体年人均自杀死亡率为0.7%,年人均自杀未遂率为2.2%,年人均自杀行为率为2.9%.结论 部分自杀未遂者会再次出现自杀行为,而既往有自杀未遂史和有精神障碍的自杀未遂者更易再次发生自杀行为.  相似文献   

10.
目的探索自杀未遂者再次实施自杀行为时是否会更换自杀方式及其相关因素。方法在自杀未遂者随访队列(n=902)中,选取所有在随访期间再次实施自杀行为的案例纳入研究,根据登记的数据,比较前后两次自杀行为是否采用同一类型的自杀方式,两次自杀方式致命性变化情况,分析是否更换自杀方式以及两次自杀方式致命性变化情况与首次自杀方式、人口学变量等因素的关系。结果共有80例自杀未遂者在随访期间再次出现自杀行为,其中45例更换自杀方式,22例因再次自杀行为死亡。首次和再次自杀行为最常采用的方式均为服农药(分别为50例和32例)。首次自杀为服农药的自杀未遂者中,再次自杀行为有23例仍用农药,19例选择更低致命性的方式。首次自杀为过量服治疗药的19例自杀未遂者在再次自杀行为时有11例选用更高致命性的方式。多因素logistic回归分析提示,首次自杀为过量服治疗药的再次自杀者易更换自杀方式(OR=11.92,95%CI:1.86~76.23,P=0.009)。结论自杀未遂者再次实施自杀行为时更换自杀方式比较常见,尤其是首次自杀为过量服治疗药者。而农药管控依然是重要的预防自杀措施。  相似文献   

11.
Although suicidality remains highly prevalent among patients with bipolar disorder, little research exists examining the characteristics of successive attempts among individuals who make and survive a first suicide attempt. We compared bipolar subjects with a history of one suicide attempt to those with multiple attempts and assessed demographic characteristics, family histories, psychopathology, and clinical dimensions of suicidal behavior. Fifty-two DSM-IV bipolar patients (age 21 to 74 years) with a history of at least one suicide attempt were consecutively evaluated in the Bipolar Disorders Research Clinic of the New York Presbyterian Hospital. Circumstances surrounding each lifetime suicide attempt were assessed by direct interviews, questionnaires, and chart reviews along with family psychiatric histories, substance abuse histories, current psychopathology, and features of impulsivity and aggression. Multiple suicide attempts occurred in approximately two thirds of the study group. Single attempters were significantly more likely than multiple attempters to show high seriousness of intent at their first attempt (OR = 0.65, 95% CI = 0.43 to 0.99), and tended to be less likely than multiple attempters to exhibit mixed states at their first attempt (OR = 0.54, 95% CI = 0.28 to 1.01). Seriousness of intent was consistent across the first and second attempts (r =.48, P <.01) and second and third attempts (r =.74, P <.05). Single and multiple attempters differed in no other clinical or demographic characteristics studied. We conclude that multiple suicide attempts are common among bipolar patients. Those who survive an initial suicide attempt involving high seriousness of intent appear less likely than those with low intent to make subsequent attempts. Consequently, single attempters may represent a group more closely resembling those who complete suicide on a first attempt, in terms of the risk for death associated with their first attempt. However, multiple suicide attempts among bipolar patients are not necessarily associated with a higher risk for lethality in first suicide attempt survivors.  相似文献   

12.
A retrospective chart review of black suicide attempters was completed to describe the sample in comparison to prior studies and to develop preventive strategies. This sample of 56 black suicide attempters was composed of 17 males and 39 females, a ratio of 1:2.3. Female attempters were younger, 54% had made a prior attempt and had a diagnosis of either affective illness (33%) or an adjustment reaction with depressive features (31%). Male attempters were older, 76% had a prior psychiatric history, and 59% had a psychotic diagnosis. The potential for life-threatening behavior in psychotic black male patients was noted. The necessity of monitoring the access to medication by stressed impulsive youth was emphasized. As significant others involved in the stressers that precipitated the attempt accompanied the patient to the emergency room (ER), crisis intervention in the ER with the signficant other and/or family members was identified as an important strategy.  相似文献   

13.
Although many authors have described eating disorders as often being associated with suicidal feelings and behaviour, few studies to date have evaluated the prevalence and characteristics of suicidal behaviour in eating disordered patients. In the present study, in which a consecutive series of 495 out-patients was studied, 13% of the patients reported at least one suicide attempt and 29% reported current suicidal ideation; 26% of attempters reported multiple attempts. A history of suicide attempt was more prevalent among binge-eating/purging anorexics and among purging bulimics than in the other subgroups. In cases with anorexia nervosa, suicide attempters were older, had a longer illness duration, weighed less, had more often used drugs and/or alcohol and tended to be more obsessive than non-attempters. In cases with bulimia nervosa, attempters presented with more psychiatric symptoms and had more frequently been sexually abused.  相似文献   

14.
BackgroundVarious explanations account for suicide incidents, and some patients continue to attempt afterwards and others never again. The suicide mortality rate increases with the number of serious attempts. The prevention of secondary attempt of suicide should be an important approach to reduce suicide mortality. However, the characteristics of the targeted population of repeated suicide attempters are understudied.MethodsThis was a cross-sectional data collection from hospital emergency room from patients who had either attempted suicide for the first time (n = 721) or for two or more times (n = 70). The subjects were between 14 and 53 years old and comprised 293 males and 498 females. In-depth interview was conducted for each suicide attempter with a semi-structural protocol. Demographic and social-psychological characteristics were compared between the two groups of suicide attempters. Logistic regression was used to identify independent predictors of multiple attempts.FindingsThe two groups only differed in religion factor among demographic characteristics and multiple suicide attempters group have a higher percentage of subjects who reported to have a religion affiliation than first time suicide attempters. Multiple attempters were more likely to have family suicide history, physical illness, mental disorder, higher scores on Beck Hopelessness Scale (BHS) and Suicide Intent Scale (SIS) and lower scores on Duke Social Support Scale (DSSI). In the final regression model, family history of suicide, mental disorder, hopelessness and social support emerged as significant predictors of multiple suicide attempts.ConclusionSuicide attempters that have mental disorder, family history of suicide, higher level of hopelessness and lower level of social support are more likely to re-attempt suicide again. Social and clinical interventions may have to also focus on this sub-group of patients with these characteristics to effectively reduce suicide mortality rate.  相似文献   

15.
This study examined the relationship between family history of suicide, negative problem solving orientation and suicide attempt status (multiple suicide attempters versus single suicide attempters). Suicide attempters with a family history of suicide were more likely to have multiple suicide attempts when compared to suicide attempters who did not have a family history of suicide. This relationship was consistent with a model in which the relationship between family history and suicide attempt status is mediated by negative problem solving. Results of this study are discussed as they pertain to the theory and treatment of suicide attempters.  相似文献   

16.
Of 74 panic disorder subjects followed up after 7 years, five reported serious suicide attempts and three had completed suicide. Compared with subjects who had not made serious attempts, the serious suicide attempters (including the three suicides) were younger, and fewer of them were married. Also, the serious attempt group had an earlier, more gradual onset of illness. More of the serious attempters had personality disorders and coexisting major depression. At the time of original assessment, the serious attempters had more severe symptoms. These data suggest that among patients with panic disorder, serious suicidal behavior is associated with more severe psychopathology.  相似文献   

17.
OBJECTIVE: No previous study has comprehensively investigated the pattern of health care contacts among elderly subjects attempting suicide. The present study compared elderly suicide attempters with younger attempters, before and after attempted suicide, in terms of health care contacts, clinical diagnoses of mental disorders, and characteristics predicting lack of treatment contact after the index attempt. METHODS: All consecutive 1198 suicide attempters treated in hospital emergency rooms in Helsinki, Finland, from 15.1.1997 to 14.1.1998 were identified and divided into two age groups: (1) elderly suicide attempters aged 60 years or more (n = 81) and (2) suicide attempters aged under 60 years (n = 1117). RESULTS: During the final 12 months before the attempt, the majority of elderly suicide attempters had a contact with primary health care, but their mood disorders were likely to have remained undiagnosed before the index attempt. In primary health care, only 4% had been diagnosed with a mood disorder before the attempt, but 57% after (p < 0.001). After the suicide attempt, most elderly suicide attempters were referred for aftercare, two thirds having contact with psychiatric care. CONCLUSIONS: For purposes of preventing suicidal behaviour, screening for depression, plus further education on recognition, diagnosis and treatment of mood disorders among the elderly in primary health care setting are needed.  相似文献   

18.
The number of suicide attempts in developing countries has been increasing progressively, as in the West. It is important to note that much of the data on suicidal behaviour is based on information obtained from developed Western societies. All such data need to be evaluated within their specific cultural context as well as cross-culturally. The present study explored the various socio-demographic, clinical characteristics of suicide attempters in a general hospital unit in India. There were certain findings that contrasted markedly with those observed in the West. Male suicides tended to predominate here, as in many Indian studies. None of them were living alone, separated or deserted by their partner. Some suicide attempters continued to live with their extended family. There was virtually no alcohol consumption by female suicide attempters. The commonest agents used were organophosphates and other household poisons. Several cross-cultural variations in the suicidal act emerged compared to the West. The 'suicide potential’ in the Indian culture is discussed.  相似文献   

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