血清胆固醇和吸烟与精神分裂症自杀意念

目的 探讨男性精神分裂症患者中自杀意念和血清胆固醇水平及吸烟状况的关系。方法 196例精神分裂症患者分为自杀意念组和无自杀意念组，进行血清胆固醇水平的测定，并记录患者吸烟情况。结果 自杀意念组血清胆固醇水平明显低于无自杀意念组。吸烟患者中自杀意念发生率高。结论 低血清胆固醇水平和吸烟可增加精神分裂症患者自杀的危险。     

67例抑郁障碍伴自杀行为的临床对照研究

探讨抑郁障碍患者发生自杀行为的相关因素与预测。方法对６７例有自杀行为和１０８例无自杀行为的抑郁障碍进行了临床对照分析。结果高文化程度和城镇居民抑郁障碍患者自杀行为发生率高。结论Ｈａｍｉｌｔｏｎ抑郁量表总分不能作为预测抑郁障碍自杀危险性的有效指标，而焦虑／躯体化与绝望感因子分对抑郁障碍自杀危险性的预测有一定价值。     

Alcohol Use as a Potential Mediator of Forced Sexual Intercourse and Suicidality Among African American, Caucasian, and Hispanic High School Girls

Purpose

Sexual assault on adolescent females is a major public health concern. The purposes of this study were to examine: (1) whether alcohol use mediates the relationship between forced sexual intercourse and suicidality in high-school girls, and (2) whether this mediation differs by ethnicity.

Methods

Using cross-sectional data from the 2009 Youth Risk Behavior Survey (n = 6,294), we used logistic regression and simple mediation using the Sobel test for indirect effect for our analyses.

Results

Overall rates for forced sexual intercourse, alcohol use, and suicidality were 10.9%, 56.6%, and 18%, respectively. Current alcohol use significantly mediated the relationship between forced sexual intercourse and suicidality in African American, Caucasian, and Hispanic high-school girls. Overall, 13% of variance in participants' suicidality can be accounted for by the indirect effect of forced sexual intercourse on suicidality through alcohol use. The amount of variance accounted for by alcohol use varied significantly by ethnicity, with the largest amount of variance (21%) accounted for suicidality in Hispanic girls.

Conclusion

In addition to its acute affects, alcohol use may serve as a general risk factor for suicidality in girls who have experienced forced sexual intercourse. Intervention programs targeting female adolescent sexual assault victims should include an alcohol use component.     

Suicidal ideation among patients with gender identity disorder

In this study, we tried to clarify the prevalence of suicidal ideation and self-mutilation including suicide attempts among patients with gender identity disorder (GID) and the relationship of those behaviors to demographic characteristics. A total of 500 consecutive Japanese GID patients without any other psychiatric comorbidity were evaluated at the outpatient GID Clinic of Okayama University Hospital. The lifetime rate of suicidal ideation was 72.0% of the total sample. There were no significant differences in the prevalence of suicidal ideation among groups divided by sex, age, age at onset or education. The lifetime prevalence of self-mutilation including suicide attempts was 31.8% of the total sample. Low level of education was significantly related to self-mutilation among both male-to-female and female-to-male GID patients. Younger age at onset was a significant factor affecting self-mutilation only among MTF GID patients. A lack of strategies to cope with severe distress among persons with lower education might induce a high frequency of self-mutilation including suicidal attempt. GID patients with a low level education might be at high risk of self-mutilation and should be watched with special attention to self-mutilation.     

Qualitative content analysis of suicidal ideation in Korean college students

The suicide rate for ages 15-24 increased recently in South Korea. The purpose of this study was to understand the suicidal ideation using the qualitative content analysis in South Korean college students. The data were collected with non-structured open questions in 134 college students and were analyzed with qualitative content analysis. The collected materials were classified 2 categories, 6 themes, and 21 theme clusters. Two categories are emerged: (1) facilitators of suicidal ideation, and (2) inhibitors of suicidal ideation. This study identified that the facilitators of suicidal ideation are physical, psychological and societal concerns, and suggested that the inhibitors of suicidal ideation are influenced by religious and cultural context. These results presented that Buddhism and Confucianism had influence on reasons to not attempting suicide behavior as the inhibitor of suicidal ideation. In conclusion, cultural context should be considered to develop strategies for the suicide prevention in South Korean college student.     

Making sense of suicide: a discourse analysis of young people's talk about suicidal subjecthood

Though there is a substantial body of literature on youth suicide, relatively few studies provide a detailed analysis of young people's own understandings of suicidal behaviour. The present research pays particular attention to how young people make sense of suicide, in the understanding that suicide only becomes possible insofar as it is imaginable. Interviews and focus groups (including 69 participants in total) with people aged 16-24 years provide the empirical material for this study. Research participants were recruited across a range of ethnic groups and sexual orientations, and drawn from rural and urban areas in the North of England and South Wales. Four frameworks for understanding youth suicide are discussed in this paper. These frameworks of understanding variously (i) cast suicidal subjects as Other, (ii) highlight suicide as something that is accessible to young people, (iii) demonstrate the desire to rationalise suicidal behaviour, and (iv) define suicidal subjects in terms of their relationships with others. The interwoven meanings that run through these four frameworks, and their connection with existing literature, are discussed and the implications for suicide prevention are indicated.     

A comparison of specific positive future expectancies and global hopelessness as predictors of suicidal ideation in a prospective study of repeat self-harmers

BACKGROUND: Hopelessness and the lack of positive future expectancies have been related to suicidality. This is the first study to compare the power of positive future expectancies and global hopelessness in the prediction of suicidal ideation. In short, are specific positive expectancies or global hopelessness attitudes more closely related to suicidality? METHOD: One hundred and forty four adults hospitalized following a suicidal self-harm episode completed a range of clinical and psychological measures in hospital and were followed up approximately 2.5 months after discharge. All participants reported at least one other self-harm episode in addition to the index episode. RESULTS: Hierarchical regression analyses confirmed that specific positive future expectancies were better predictors of Time 2 suicidal ideation than global hopelessness. In addition, as hypothesized, negative future thinking was not independently associated with suicidal ideation. LIMITATIONS: Short-term follow-up. CONCLUSIONS: Specific, idiographic expectancies for positive events (i.e., positive future thinking) are more important predictors of suicidal ideation than global attitudes of hopelessness. Unlike global hopelessness, they provide more options for intervention (e.g., identifying life goals and plans). These findings are particularly noteworthy given the widespread use of measures of global hopelessness. The theoretical and clinical implications are discussed.     

Sleep problems, suicidal ideation, and self-harm behaviors in adolescence

Objective

Previous research has found an association between sleep problems and suicidal behavior. However, it is still unclear whether the association can be largely explained by depression. In this study, we prospectively examined relationships between sleep problems when participants were 12-14 years old and subsequent suicidal thoughts and self-harm behaviors—including suicide attempts—at ages 15-17 while controlling for depressive symptoms at baseline.

Methods

Study participants were 280 boys and 112 girls from a community sample of high-risk alcoholic families and controls in an ongoing longitudinal study.

Results

Controlling for gender, parental alcoholism and parental suicidal thoughts, and prior suicidal thoughts or self-harm behaviors when participants were 12-14 years old, having trouble sleeping at 12-14 significantly predicted suicidal thoughts and self-harm behaviors at ages 15-17. Depressive symptoms, nightmares, aggressive behavior, and substance-related problems at ages 12-14 were not significant predictors when other variables were in the model.

Conclusions

Having trouble sleeping was a strong predictor of subsequent suicidal thoughts and self-harm behaviors in adolescence. Sleep problems may be an early and important marker for suicidal behavior in adolescence. Parents and primary care physicians are encouraged to be vigilant and screen for sleep problems in young adolescents. Future research should determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents.     

Sleep problems and suicidality in the National Comorbidity Survey Replication

Objective

Links between sleep problems and suicidality have been frequently described in clinical samples; however, this issue has not been well-studied in the general population. Using data from a nationally representative survey, we examined the association between self-reported sleep difficulties and suicidality in the United States.

Methods

The WHO Composite International Diagnostic Interview was used to assess sleep problems and suicidality in the National Comorbidity Survey Replication (NCS-R). Relationships between three measures of sleep (difficulty initiating sleep, maintaining sleep, early morning awaking), and suicidal thoughts, plans, and attempts were assessed in logistic regression analyses, while controlling for demographic characteristics, 12-month diagnoses of mood, anxiety and substance use disorders, and chronic health conditions.

Results

In multivariate models, the presence of any of these sleep problems was significantly related to each measure of suicidality, including suicidal ideation (OR = 2.1), planning (OR = 2.6), and suicide attempt (OR = 2.5). Early morning awakening was associated with suicidal ideation (OR = 2.0), suicide planning (OR = 2.1), and suicide attempt (OR = 2.7). Difficulty initiating sleep was a significant predictor of suicidal ideation and planning (ORs: 1.9 for ideation; 2.2 for planning), while difficulty maintaining sleep during the night was a significant predictor of suicidal ideation and suicide attempts (ORs: 2.0 for ideation; 3.0 for attempt).

Conclusions

Among community residents, chronic sleep problems are consistently associated with greater risk for suicidality. Efforts to develop comprehensive models of suicidality should consider sleep problems as potentially independent indicators of risk.     

抑郁症患者治疗前后自杀意念比较及影响因素分析

目的评估抗抑郁剂对抑郁症患者自杀意念的疗效和调查自杀意念的危险因素。方法选择58例门诊抑郁症患者,以特质应对方式问卷(TCSQ)、匹兹堡睡眠质量指数量表(PSQI)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)和自杀意念自评量表(SIOSS)评估患者的应对方式及治疗前后睡眠质量、抑郁焦虑症状和自杀意念,比较治疗前后临床症状变化及自杀意念的影响因素。结果(1)治疗第3月末HAMD[(9.66±6.95)分]、HAMA[(9.52±7.66)分]、PSQI[(9.52±4.67)分]、SIOSS[(7.31±6.22)分]各量表评分较治疗前均有非常显著改善;(2)离婚或丧偶(t=2.016,P=0.049)、受教育年限越长(t=3.272,P=0.002)、伴有慢性躯体疾病(t=3.601,P=0.001)、消极应对因子分较高(t=5.151,P=0.000)和积极应对因子分较低(t=2.444,P=0.018)、治疗前睡眠障碍较严重(t=3.861,P=0.000),自杀意念程度明显较严重;(3)女性(t=2.082,P=0.043)、已婚(t=5.486,P=0.000)、无慢性躯体疾病(t=2.067,P=0.044)、首发(t=5.773,P=0.000)、积极应对因子分较低(t=4.533,P=0.000)、治疗前睡眠障碍较严重(t=4.385,P=0.000),以及治疗后抑郁(t=6.650,P=0.000)、焦虑(t=4.506,P=0.000)和睡眠障碍(t=2.798,P=0.007)改善较明显者,治疗后患者的自杀意念改善程度较显著。结论抑郁症患者的自杀意念影响因素是多方面的,可以通过积极的抗抑郁药物治疗和综合干预获得缓解。