广东省怀集县中学生自杀未遂状况调查及相关因素分析

目的了解广东省怀集县中学生自杀未遂的报告率,探讨其危险因素,为实施心理危机干预提供依据。方法采用分层整群随机抽样方法,在广东省怀集县两所中学每个年级各抽取2个班级共12个班级的593名学生为调查对象。采用自编人口学问卷、自杀未遂调查表进行匿名调查。通过Logistic回归模型探讨自杀未遂相关因素。结果共567份(95.6%)问卷纳入最终分析。被访者平均年龄(15.1±11.6)岁,女生293名(51.7%)。自杀未遂率为4.8%,女男自杀未遂率比为2.2:1。女性(OR=3.4,95%CI:1.2~9.3)、认识的本校同学有自杀行为(OR=15.4,95%CI:5.9~40.2)、近一个月因心理问题影响学习(OR=9.2,95%CI:2.8~30.4)是既往自杀未遂的独立危险因素,班主任为女性(OR=0.2,95%CI:0.1~0.5)可能是独立保护性因素。结论怀集县中学生,尤其是女生自杀未遂发生率高,应根据研究发现的自杀未遂相关因素在怀集县建立有针对性的自杀预防体系。     

抑郁障碍患者自杀未遂的危险因素分析

目的:分析抑郁障碍(MDD)患者自杀未遂的危险因素。方法:入组332例MDD患者,分为自杀未遂组(95例)和非自杀未遂组(237例);对入组者进行人口学与临床资料调查、汉密尔顿抑郁量表(HAMD-24)及汉密尔顿焦虑量表(HAMA-14)评估及血清甲状腺功能检测,并进行组间比较;分析自杀未遂的危险因素。结果:自杀未遂组年龄、首次发病年龄明显小于非自杀未遂组,病程、既往住院次数明显多于非自杀未遂组;单身、无业、受教育程度低、家族史阳性、伴有精神病性症状、共病焦虑障碍比率明显高于非自杀未遂组(P<0.05或P<0.01)。HAMD总分与焦虑躯体化、认知障碍、阻滞、绝望感、体质量、日夜变化因子分及HAMA评分明显高于非自杀未遂组(P<0.05或P<0.01)。血清游离三碘甲状腺原氨酸(FT3)水平明显高于非自杀未遂组(P<0.05)。多因素Logistic回归分析显示,伴有精神病性症状、既往住院次数、HAMD评分中认知障碍、绝望感因子是影响抑郁症患者自杀未遂的主要危险因素。结论:伴有精神病性症状、既往住院次数、HAMD评分中的认知障碍、绝望感因子可能为MDD患者...     

双相障碍中自杀未遂的危险因素

双相障碍与自杀有明显的联系,而双相障碍患者的自杀未遂则是预测其自杀死亡的重要标记之一,故本文对双相障碍中自杀未遂的危险因素作一综述,为预防双相障碍患者的自杀提供必要的参考。     

伴非典型特征的抑郁症患者自杀未遂的危险因素分析

目的探讨伴非典型特征抑郁症患者自杀未遂的社会人口学及临床特征方面危险因素。方法来自全国13个中心的1172例抑郁症患者,纳入其中179例伴非典型特征患者,依据简明国际神经精神访谈(the Mini International Neuropsychiatric Interview,MINI)5.0中文版自杀模块的访谈结果,分为自杀未遂组和无自杀未遂组,通过多因素logistic回归分析伴非典型特征的抑郁症患者在性别、年龄等社会人口学资料及伴焦虑症状、伴精神病性症状等临床特征方面可能与自杀未遂相关的危险因素。结果伴非典型特征抑郁症患者自杀未遂的发生率为23.5%(42/179)。与无自杀未遂组患者相比,自杀未遂组患者更多伴有自杀观念、产后起病,更常使用抗抑郁剂以外的其他药物治疗(如抗精神病药、情感稳定剂及苯二氮类药)(均P0.05)。多因素logistic回归分析显示,既往住院次数(OR=1.730,95%CI:1.093~2.740)和自杀观念(OR=3.899,95%CI:1.506~10.092)与伴非典型特征的抑郁症患者发生自杀未遂相关(均P0.05)。结论既往住院次数多及伴有自杀观念是伴非典型特征抑郁症患者自杀未遂的主要危险因素。     

住院老年痴呆患者营养状况及相关因素调查

目的调查住院老年痴呆患者营养状况并探索相关因素,为对老年痴呆患者开展整合型照护服务提供参考。方法采用整群抽样方法选取在广元市精神卫生中心住院的339例老年痴呆患者为研究对象,采用简短营养状况量表(MNA)、简易精神状态评价量表(MMSE)、患者健康问卷抑郁量表(PHQ-9)和口腔卫生筛查量表(D-E-N-T-A-L)进行评定。依据MNA评分计算营养不良与潜在营养不良的发生率,采用有序Logistic回归分析和多元Logistic回归分析探索营养不良的影响因素。结果共检出有营养问题的老年痴呆患者235例(69. 3%),其中营养不良151例(44. 5%),潜在营养不良84(24. 8%)。住院老年痴呆患者营养状况的影响因素分别为已婚(OR=0. 58,95%CI:0. 35～0. 95,P=0. 03)、口腔健康状况(OR=1. 26,95%CI:1. 04～1. 51,P=0. 02)、抑郁(OR=1. 09,95%CI:1. 05～1. 13,P0. 01)和认知功能(OR=0. 92,95%CI:0. 90～0. 95,P0. 01)。结论营养不良在住院老年痴呆患者中较常见,无配偶、口腔健康状况不良、存在抑郁情绪以及认知功能受损是营养不良的主要相关因素。     

自杀未遂再自杀危险因素及其干预的研究进展

研究发现自杀未遂者可能不止一次出现自杀行为,直至最终导致自杀死亡。本文归纳了自杀未遂再自杀的危险因素及再自杀的干预措施。     

上海部分医院自杀未遂相关因素分析

目的 调查上海部分综合医院和精神卫生中心自杀未遂者的自杀行为特征和相关因素,为制定自杀预防及干预措施提供依据.方法 使用自编的自杀未遂者调查登记表对就诊于急诊和门诊的自杀未遂者进行调查,数据输入SPSS统一分析.结果 363例自杀未遂者中女性245(67%)与男性118(33%)的比例为2:1.平均年龄33±16.8岁...     

自杀未遂相关因素及认知行为治疗

自杀作为四种公共卫生问题之一，严重的威胁人们的生命安全及心理健康，越来越受到人们的重视，而自杀人群中自杀未遂者约为自杀死亡人群的20倍，并且自杀未遂者再次自杀的比例较高，因此自杀未遂人群的干预与治疗显得格外重要。国内外研究发现认知行为治疗在自杀未遂者干预中取得了一定的效果，本文就国内外关于自杀相关因素及自杀未遂人群的认知行为治疗等方面作一综述。     

自杀未遂者社会心理因素调查分析

目的：探讨社会心理因素与自杀未遂的关系。方法：采用自制的《自杀未遂者社会心理因素调查表》对1996年4月-2001年4月期间在我市急救中心的自杀未遂者进行调查。结果：自杀未遂者以女性多见。年龄在25-35岁最多；均有明显精神因素。依次为恋爱婚姻受挫，家庭内部矛盾，家庭经济困难或失业，人际关系紧张等，自杀未遂的方式与性别，年龄，受教育程度有关。结论：自杀未遂的发生与社会心理因素密切相关。自杀方式与年龄，性别，受教育程度有关。     

冲动性和攻击性对大学生自杀未遂行为的影响

目的 了解冲动性及攻击性对大学生自杀未遂行为的影响.方法 采用<自杀态度与心理健康状况问卷(大学版-Ⅳ)>对重庆市随机抽取的11所大学的12000名大学生进行调查.比较有无自杀未遂大学生中文版Barratt冲动行为量表与Buss和Perry攻击问卷的评估结果,分析冲动性及攻击性人格对大学生发生自杀行为的影响.结果 收集有效问卷9808份,大学生自杀未遂的报告率为1.7%(169/9808).自杀未遂组的冲动行为量表中的非计划性、行动冲动性和认知冲动性及总分均高于无自杀未遂组(P<0.001).自杀未遂组Buss和Perry攻击问卷的总分及身体攻击、言语攻击、愤怒、敌意、指向自我的攻击等各因子分均高于无自杀未遂组(P<0.01).多因素条件logistic回归分析显示,与自杀未遂最密切有关的独立危险因素排列为:攻击性总分高(OR=20.81,95%CI:12.36～35.03,P<0.01),行动冲动性分高(OR=4.32,95%CI:2.33～8.01,P<0.01).冲动性总分高(OR=3.37,95%CI:1.65～8.42,P<0.01),非计划性分值高(OR=3.12,95%CI:1.75～5.56,P<0.01),自杀意念强(OR=2.54,95%CI:1.75～3.70,P<0.01),已发生过性行为(3.12,95%CI:1.75～5.56,P<0.01),女性(OR=2.15,95%CI:1.48～3.14,P<0.01),指向自我的攻击分值高(OR=1.89,95%CI:1.24～2.88,P<0.01).结论 有自杀未遂的大学生更多体现出冲动性及攻击性人格,对大学生冲动性自杀行为应采取不一样的干预方案.     

抑郁症未遂自杀及相关因素研究

对１４０例抑郁症患者的未遂自杀及相关因素进行研究，发现未遂自杀发生率为３４．２９％。与对照组相比，发生未遂自杀的４８例有以下特点：年龄较大、多有阳性家族史、个人经济收入较低，发病多有诱因、多为急性起病、ＨＡＭＤ睡眠障碍和绝望感因子分较高、迟缓因子分较低、多为单相抑郁症。逐步回归分析发现，影响未遂自杀的因素主要为ＨＡＭＤ睡眠障碍、绝望感、迟缓因子分。     

Self-harm, suicidal ideation and suicide attempts among college students

Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk.     

农村未遂自杀者的再自杀意念及相关因素研究

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。     

Dementia,suicide attempts and suicide. A case study

The prevalence of suicide or attempts to suicide in patients with any sort of dementia has not been sharply established. The only figures found through a bibliographic search on Medline belong to a paper by Larson (13) dated 1963, who points out that only 0,8 per cent of men and 0,3 per cent of women suffering dementia commit suicide. Although persons over 65 years old are less than the 13 per cent of the world total population, they actually commit between the 17 per cent and the 25 per cent of all the suicides. Usually it was claimed that people with dementia do not commit suicide, on one hand, because of the failure in the executive abilities and in the capability to carry it on, and due to the lost of insight, on the other, both of them acting as protective factors. The aim of this article is to analyse the five clinical cases of patients with dementia that were hospitalized in a psychiatric service of a general hospital after trying to commit suicide, and then compare these cases with other four cases of patients with dementia that commit suicide reported in the international literature.     

重复自杀行为众多影响因素分析

目的探讨重复自杀行为者的特点及其自杀的危险因素。方法采用WHO健康量表、Beck抑郁自评量表、自杀强度量表等对115例住院的自杀未遂者实施调查,并追踪随访6年,对整个病程中仅有单次自杀行为和重复自杀行为两类人群住院时人文特点及评估资料进行比较。结果115例自杀未遂者中重复自杀行为24例,占20.9%。24例重复自杀行为者就诊治疗时年龄42.6±13.2岁,WHO健康量表得分7.04±5.64,Beck抑郁自评得分26.25±17.36,自杀强度得分10.04±4.94,16例(66.7%)患有精神疾病;91例单次自杀行为者年龄32.6±13.9岁,WHO健康量表得分15.91±5.61,Beck抑郁自评得分6.82±10.51,自杀强度得分7.76±3.97,20例(22.0%)患有精神疾病。重复与单次自杀行为者比较,两组在年龄、WHO健康量表、Beck抑郁自评得分、自杀强度得分、有无精神疾病以及自杀方式、是否真的想死、是否存在困扰1年以上躯体病或残疾、未来没有希望、身体健康状况自评方面存在明显差异(均P<0.05)。回归分析显示,自杀强度得分与是否真的想死得分相加代表的自杀致死倾向(P=0.036,OR=2.85,β=1.047),WHO健康量表与身体健康自评得分相加所代表的健康心理状态(P=0.026,OR=0.320,β=-1.141)进入回归方程。结论重复自杀行为者多患有精神疾病,抑郁心境、无望、自杀强度高等。有效评估这些因素对了解或防范未遂者再次出现自杀风险有重要意义。     

A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder

No longitudinal study has examined risk factors for future suicide attempts in major depressive disorder in a nationally representative sample. The objective of this study was to investigate baseline sociodemographic characteristics, comorbid mental disorders, specific depressive symptoms, and previous suicidal behavior as potential risk factors for suicide attempts at 3 years follow-up. Data came from the national epidemiologic survey on alcohol and related conditions (NESARC), a large nationally representative longitudinal survey of mental illness in adults [Wave 1 (2001-2002); Wave 2 (2004-2005) n = 34,653]. Logistic regression examined associations between risk factors present at Wave 1 and suicide attempts at Wave 2 (n = 169) among individuals with major depressive disorder at baseline assessment (n = 6004). Risk factors for incident suicide attempts at Wave 2 (n = 63) were identified among those with major depressive disorder at Wave 1 and no lifetime history of suicide attempts (n = 5170). Results revealed specific comorbid anxiety, personality, and substance use disorders to be associated with incident suicide attempts at Wave 2. Comorbid borderline personality disorder was strongly associated with suicide attempts in all models. Several comorbid disorders were strongly associated with suicide attempts at Wave 2 even after adjusting for previous suicidal behavior, notably posttraumatic stress disorder (adjusted odds ratio (AOR) = 2.20; 95% confidence interval (95% CI) 1.27-3.83) and dependent personality disorder (AOR = 4.43; 95% CI 1.93-10.18). These findings suggest that mental illness comorbidity confers an increased risk of future suicide attempts in major depressive disorder that is not solely accounted for by past suicidal behavior.     

Risk factors related to lifetime suicide attempts in acutely admitted bipolar disorder inpatients

Finseth PI, Morken G, Andreassen OA, Malt UF, Vaaler AE. Risk factors related to lifetime suicide attempts in acutely admitted bipolar disorder inpatients.
Bipolar Disord 2012: 14: 727–734. © 2012 The Authors.
Journal compilation © 2012 John Wiley & Sons A/S. Objective: The main aim of this study was to assess possible clinical characteristics of acutely admitted bipolar I disorder (BD‐I) and bipolar II disorder (BD‐II) inpatients at high risk of suicide by comparing patients who had made one or several serious suicide attempts with patients who had not. Methods: A total of 206 consecutive patients (mean age 42 ± 15 years; 54.9% women) with DSM–IV diagnosed BD‐I (n = 140) and BD‐II (n = 66) acutely admitted to a single psychiatric hospital department from November 2002 through June 2009 were included. Using a detailed retrospective questionnaire, patients with a history of a serious suicide attempt were compared to those with no history of a suicide attempt. Results: Ninety‐three patients (45.1%) had a history of one or more serious suicide attempts. These constituted 60 (42.9%) of the BD‐I patients and 33 (50%) of the BD‐II patients (no significant difference). Lifetime suicide attempt was associated with a higher number of hospitalizations due to depression (p < 0.0001), antidepressant (AD)‐induced hypomania/mania (p = 0.033), AD‐ and/or alcohol‐induced affective episodes (p = 0.009), alcohol and/or substance use (p = 0.002), and a family history of alcohol abuse and/or affective disorder (p = 0.01). Suicide attempt was negatively associated with a higher Positive and Negative Syndrome Scale for Schizophrenia (PANSS) Positive Subscale score (p = 0.022) and more hospitalizations due to mania (p = 0.006). Conclusions: The lifetime suicide attempt rate in BD inpatients is high. Risk factors of suicide attempts were: (i) a predominant depressive course of illness, (ii) comorbid alcohol and substance use disorders, and (iii) a history of AD‐ and/or alcohol‐induced affective episodes. Risk‐reducing factors were a preponderant manic or psychotic course of the illness. These risk factors may be signs of a clinical subgroup at risk of suicidal behaviour, and seem to be important for suicide risk assessment in acutely admitted BD patients.