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1.
为探讨抑郁症自杀未遂的危险因素,对51例有自杀未遂和152例无自杀行为的抑郁症患者进行了自杀未遂的危险因素研究。结果表明,Logistic回归筛选出的主要危险因素为自杀家族史、病前生活事件、妄想、自责自罪和绝望;单因素分析筛选出的主要危险因素为性别、自杀家族史、病前生活事件、起病形式、幻觉,妄想、焦虑激越、自责自罪和绝想。  相似文献   

2.
妄想性抑郁症55例临床分析   总被引:11,自引:1,他引:10  
对55例妄想性抑郁症与92例非妄想性抑郁症病人进行临床对照分析,结果表明,妄想性抑郁症幻听,焦虑激越,自责自罪,绝望,自杀行为等症状出现率较高,自杀率为非妄想性抑郁症的3.7倍,往往需要联合治疗方能奏效。  相似文献   

3.
妄想性抑郁症55例临床对照分析   总被引:7,自引:0,他引:7  
对55例妄想性抑郁症与92例非妄想性抑郁症病人进行临床对照分析。结果表明:妄想性抑郁症幻听、焦虑、自责自罪、绝望、自杀行为等症状出现率较高,自杀率为非妄想性抑郁症的3.7倍,往往需要联合治疗。  相似文献   

4.
目的:探讨抑郁症患者自杀的危险因素及生物学指标.方法:以抑郁症患者入院时有无自杀行为分为自杀组和无自杀组.用汉密尔顿抑郁量表(HAMD,24项)、生活事件量表(LES)及自行编制的自杀行为调查表对入组患者进行调查;酶法测定两组患者的总胆固醇(CHO)、三酰甘油(TG)、高密度脂蛋白(HDL-C)和低密度脂蛋白(LDL-C)水平.结果:共107例.多因素Logistic回归分析发现,自杀与既往自杀行为、内向性格、生活事件、严重的抑郁(尤其是绝望感明显,存在严重的认识障碍)有关;两组的血脂水平差异无显著.结论:既往自杀行为、内向性格、生活事件、严重的抑郁是抑郁症患者自杀的主要危险因素;抑郁症患者的自杀可能与血脂水平无关.  相似文献   

5.
为探讨妄想性与非妄想性抑郁症的临床特征差异,对71例妄想性抑郁症与132例非妄想性抑郁症进行了临床对照研究。结果显示,妄想性抑郁症的精神病家族史、幻觉、自责自罪、绝望、自杀行为等出现率显高于非妄想性抑郁症;妄想性抑郁症的自杀行为危险必理非妄想性抑郁症的1.99倍;妄想性抑郁症可能需联合治疗。提示妄想抑郁症可能抑郁症中的一种独特的亚型,值得进一步探讨。  相似文献   

6.
住院精神疾病患者自杀调查   总被引:2,自引:0,他引:2  
对我院建院以来自杀身亡的病例进行调查分析1 一般资料1975~ 2 0 0 1年期间 ,我院共收治精神疾病患者 2 2 917例次 ,自杀身亡者 15例。其中男 9例 ,女 6例。年龄 2 2~ 49岁 ,平均 31 7岁 ,其中 2 2~ 39岁 12例。文盲 1例 ,小学 3例 ,中学 10例 ,大学 1例。已婚 6例 ,未婚 9例。2 临床分析诊断为精神分裂症 12例 ,精神分裂症后抑郁 1例 ,抑郁症 2例。伴有躯体疾病 2例。均无精神疾病家族史。住院前有轻生意念或自杀行为者 4例。自杀由精神病性症状 (幻觉、妄想 )所致 9例 ,由抑郁、自责所致 4例 ,由生活事件、心理负担所致 2例。自杀方…  相似文献   

7.
负性生活事件与自杀行为研究   总被引:3,自引:1,他引:2  
目的 评估自杀研究用生活事件量表的效度并了解负性生活事件在自杀行为发生中的影响机制.方法 制定了一个由调查员询问填写的自杀研究用生活事件量表,以有自杀行为者为研究对象,调查[1]926例自杀死亡和756例其他伤害死亡案例(对照组)的家属和周围知情人;[2]570例自杀未遂者本人及其知情亲友,并对其中212例按年龄(±5岁)、性别配对从急诊非自杀病人的家属中选择对照进行调查.结果 两种信息来源(死者家属与周围知情人;或自杀未遂者与陪伴亲友)的同一生活事件评估指标之间的相关性较强(自杀死亡调查中急性应激强度的秩和相关系数为0.67,慢性心理压力为0.69;自杀未遂调查中分别为0.75和0.68).多因素Logistic回归分析显示,自杀当时的急性应激强度和自杀前1年内的慢性心理压力均是自杀行为发生的独立危险因素.结论 自制"自杀研究用生活事件量表"的效度良好.负性生活事件导致的急性应激和慢性心理压力对自杀行为的影响机制相对独立.  相似文献   

8.
目的:探讨社区精神分裂症患者自杀行为的相关危险因素。方法:通过自制调查问卷对成都市青羊区358例登记在册的精神分裂症患者进行调查。根据患者既往是否有自杀行为,分为有自杀行为组和无自杀行为组。采用单因素分析、多因素Logistic回归分析,探讨社区精神分裂症患者自杀行为相关的危险因素。结果:社区精神分裂症患者中发生过自杀行为的占23.5%;有幻觉及妄想(OR=1.857,P0.05)、服药不依从(OR=2.320,P0.01)、照护者对疾病知识完全不了解(OR=2.816,P0.05)是患者发生自杀行为的危险因素。结论:社区精神分裂症患者自杀风险高,患者有幻觉妄想症状及治疗不依从、患者照料者对该病不了解是患者自杀行为的危险因素。  相似文献   

9.
具有凶杀行为的精神疾病患者自杀行为研究   总被引:2,自引:0,他引:2  
目的:探讨具有凶杀行为的精神疾病患者自杀的危险因素.方法:调查1986年至2006年具有凶杀行为的精神疾病患者院内自杀身亡3l例,采用多因素Logistic回归分析自杀行为危险因素.结果:具有凶杀行为精神疾病患者自杀男:女=3.43:1,自杀行为的发生与家族自杀史、悔恨、绝望、心理社会因素及杀害对象有关.结论:悔恨、绝望、心理社会因素等是具有凶杀行为精神疾病患者自杀的危险因素,对于有凶杀行为的精神疾病患者自杀行为应加以干预.  相似文献   

10.
通过对135例住院抑郁症患者按有无自杀意念,自杀行为分组进行了对照研究,发现有自杀抑郁症患者发生自杀行为的主要因素与早醒和妄想有关,且与无自杀抑郁症者比较有显著差异,实施自杀前大多有预兆。  相似文献   

11.
Life stress has been found to be associated with onset of depression and with greater severity of depressive symptoms. It is unclear, though, if life stress is related to particular classes or specific symptoms in depression. The association between severe life events and depressive symptoms was tested in 59 individuals diagnosed by Research Diagnostic Criteria with endogenous primary nonpsychotic major depression. As predicted, life stress was associated principally with cognitive-affective symptoms, not somatic symptoms. There also was a consistent association across different assessment methods between severe events and suicidal ideation. Finally, associations held specifically for severe events occurring before onset, not for severe events occurring after onset. Symptom variation in major depression is related specifically to severe stressors before onset and includes primarily cognitive-affective types of symptoms. There is an especially pronounced association of prior severe stress with suicidal ideation. The implications of stress-symptom associations are addressed for enlarging understanding of symptom heterogeneity and subtype distinctions in major depression.  相似文献   

12.
抑郁症的自杀未遂及其危险因素分析   总被引:26,自引:0,他引:26  
为了获得抑郁症病人的自杀未遂发生率及其危险因素,采用自制的抑郁症与自杀的关系登记表和Hamilton抑郁量表,分别对符合中国精神疾病分类方案与诊断标准第2版修订本的212例住院的抑郁症病人进行调查评分,然后用SPSS和PEMS软件包进行统计分析。结果:在212例抑郁症病人中发生自杀观念158例(74.5%),自杀未遂67例(31.6%)。在自杀未遂组中的自杀方式以过量服药为主(47.8%),自杀地点多在室内(77.6%)。自杀未遂组的抑郁症状评分高于无自杀行为组(t=7.27,P<0.01)。自杀与绝望感、抑郁情绪、自卑感、自知力等呈正相关。逐步回归分析发现,绝望感对自杀的影响最大,其次是抑郁情绪,再次是自卑感和自知力。提示抑郁症与自杀的关系密切,频繁出现≥3次自杀观念的抑郁症病人发生自杀行为的可能性较大。  相似文献   

13.
Some theories explaining the background of suicidal attempts emphasise the role of depression, while others emphasise the role of hopelessness in the case of different psychological states, like psychosis. According to researches negative emotions, namely hopelessness predicts suicidal intentions more precisely than depression itself. In our study we measured the suicidal risk of our psychotic patients with hopelessness, depression and life event scales. Our results have implied that suicidal psychotic patient groups showed significantly more serious level of depression and hopelessness and had more negative life events than the non-suicidal group. Indeed, a sub-group could also be distinguished among suicidal psychotic patients in which the level of hopelessness predicts suicidal risk and not depression.  相似文献   

14.
OBJECTIVE: The authors investigated the predictive potential of a stress-diathesis model for suicidal behavior based on correlates of past suicidal acts. In this model, suicidal acts are precipitated by stressors such as life events or a major depressive episode in the setting of a propensity for acting on suicidal urges. This diathesis is expressed as the tendency to develop more pessimism in response to a stressor and/or the presence of aggressive/impulsive traits. The predictive potential of the diathesis was tested by determining whether clinical correlates of past suicidal behavior predict suicidal acts during a 2-year follow-up of patients with a major depressive episode. METHOD: Patients with DSM-III-R major depressive disorder or bipolar disorder (N=308) were assessed at presentation for treatment of a major depressive episode. Potential predictors of suicidal acts in the 2 years after study enrollment were identified on the basis of an association with previous suicidal behavior and were tested by using Cox proportional hazards regression analysis. In addition, pessimism and aggression/impulsivity factors were generated, and their predictive ability was tested by using Cox proportional hazards regression analysis. RESULTS: The three most powerful predictors of future suicidal acts were a history of suicide attempt, subjective rating of the severity of depression, and cigarette smoking, each of which had an additive effect on future risk. The pessimism and aggression/impulsivity factors both predicted suicidal acts, and each factor showed an additive effect. CONCLUSIONS: In addition to obtaining a history of suicidal behavior, clinicians may find it useful to assess patients' current level of pessimism, aggressive/impulsive traits, and comorbidity with substance use disorders, including nicotine-related disorders, to help identify patients at risk for suicidal behavior after major depression. Interventions such as aggressive pharmacotherapeutic prophylaxis to prevent relapse or recurrence of depressive symptoms may protect such at-risk individuals from future suicidal behavior.  相似文献   

15.
Fifty-seven patients with situational major depression diagnosed by the Research Diagnostic Criteria were compared with 72 subjects with nonsituational major depression on demographic, clinical, and psychosocial variables. The situational patients tended to be younger and had fewer prior episodes of depression and fewer hospitalizations. No differences were found in categories of life events, in overall clinical picture, in social supports, or in family history.  相似文献   

16.
BackgroundTo determine the prevalence of suicidal ideation and behaviour - and their correlates - in patients with persecutory delusions.Methods110 patients with persecutory delusions in the context of non-affective psychosis were assessed for suicidal thoughts and behaviours over the past month. Symptom and psychological assessments were also completed.ResultsThe severity of suicidal ideation was: no suicidal ideation (n = 26, 23.6%); wish to be dead (n = 21, 19.1%); nonspecific active suicidal thoughts (n = 14, 12.7%); suicidal thoughts with methods but no intent (n = 29, 26.4%); suicidal thoughts with intent but no specific plan (n = 13, 11.8%); and suicidal intent with plan (n = 7, 6.4%). In the past month, five patients (4.5%) had made an actual, interrupted, or aborted suicide attempt. The severity of suicidal ideation was associated with higher levels of depression, paranoia, hallucinations, anger, insomnia, negative beliefs about the self and others, pessimism, worry, and delusion safety-seeking behaviours and lower levels of psychological well-being and reward responsiveness. Severity of ideation was not associated with cannabis or alcohol use, working memory, pain, or meaningful activity levels.ConclusionsPatients with persecutory delusions are typically in a severe state of psychological stress, and at risk of suicide, as indicated by very high levels of suicidal ideation. This exploratory study also identifies correlates of suicidal ideation that could be investigated in causal research designs.  相似文献   

17.
OBJECTIVE: The lower expressing allele of the serotonin transporter gene 5' promoter region (5-HTTLPR) polymorphism is reported to be associated with susceptibility to depression and suicidality in response to stressful life events. The authors examined the relationship of a triallelic 5-HTTLPR polymorphism to stressful life events, severity of major depression, and suicidality. METHOD: Mood disorder subjects (N=191) and healthy volunteers (N=125), all Caucasian subjects of European origin, were genotyped for the triallelic 5-HTTLPR polymorphism (higher expressing allele: L(A); lower expressing alleles: L(G), S). All subjects underwent structured clinical interviews to determine DSM-IV diagnoses, ratings of psychopathology, stressful life events, developmental history, and suicidal behavior. CSF 5-HIAA was assayed in a subgroup of subjects. RESULTS: Lower expressing alleles independently predicted greater depression severity and predicted greater severity of major depression with moderate to severe life events compared with the higher expressing L(A) allele. No associations with suicidal behavior and CSF 5-HIAA were found. CONCLUSIONS: Lower expressing transporter alleles, directly and by increasing the impact of stressful life events on severity, explain 31% of the variance in major depression severity. The biological phenotype responsible for these effects remains to be elucidated.  相似文献   

18.

Background

Suicide is an important clinical problem in psychiatric patients. The highest risk of suicide attempts is noted in affective disorders.

Objective

The aim of the study was to look for suicide risk factors among sociodemographic and clinical factors, family history and stressful life events in patients with diagnosis of unipolar and bipolar affective disorder (597 patients, 563 controls).

Method

In the study, the Structured Clinical Interview for DSM-IV Axis I Disorders and the Operational Criteria Diagnostic Checklist questionnaires, a questionnaire of family history, and a questionnaire of personality disorders and life events were used.

Results

In the bipolar and unipolar affective disorders sample, we observed an association between suicidal attempts and the following: family history of psychiatric disorders, affective disorders and psychoactive substance abuse/dependence; inappropriate guilt in depression; chronic insomnia and early onset of unipolar disorder. The risk of suicide attempt differs in separate age brackets (it is greater in patients under 45 years old). No difference in family history of suicide and suicide attempts; marital status; offspring; living with family; psychotic symptoms and irritability; and coexistence of personality disorder, anxiety disorder or substance abuse/dependence with affective disorder was observed in the groups of patients with and without suicide attempt in lifetime history.  相似文献   

19.
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。  相似文献   

20.
Abstract Objective Suicide is the leading cause of premature death in patients with schizophrenia. Studies have shown a weaker association between suicidal behavior and stressful life events in schizophrenic than in nonschizophrenic subjects. The aim of the present study was to further investigate the complicated relationship of suicide attempts and life events in adolescent schizophrenic patients. Methods Forty adolescents with a diagnosis of schizophrenia, including 20 who had attempted suicide and 20 who had not, were compared with 20 age-matched subjects with no psychiatric history. The instruments used for the assessment were the Life Events Checklist, the Suicidal Risk Scale, the Sexual Abuse in Childhood Questionnaire, and the Beck Depression Inventory. Results Control subjects reported fewer life events in general, and fewer negative events, events of sexual abuse, and events associated with impaired family functioning than the schizophrenic patients. Within the schizophrenic group, the suicidal patients reported fewer life events than the nonsuicidal patients, but there was no difference between the groups in the number of negative or sexual-abuse events. However, the proportion of negative life events out of total life events was higher in the suicidal group, and their perceived impact was stronger. Levels of depression and suicidality were higher in the suicidal schizophrenic patients than in the nonsuicidal patients. Conclusions In adolescent patients with schizophrenia, suicidal behavior is associated less with the number of life events and more with their perception of the events as negative and the impact of these events on the individual.  相似文献   

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