心理干预对药物滥用者自杀意念的影响

目的：探讨心理干预对预防药物滥用者自杀意念的影响。方法：对经住院脱瘾回归社区的药物滥用者48例进行每周3次，每次1小时，病人家属每周1次，每次2小时，共4周的心理干预治疗，并与48例对照组的自杀意念进行比较。结果：研究组自杀意念量表平均分（8．7±4．2），与对照组平均分（4．1±2．9）比较有显著差异性（P〈0．01）；试验组自杀发生率、自杀频度、治疗痊愈率、对治疗的依从性明显高于对照组。结论：对药物滥用者早期危机干预、急性期治疗和巩固维持治疗及回归家庭社会全过程的综合干预，能有效预防药物滥用者发生自杀的危险。     

自杀未遂相关因素与心理干预的研究进展

自杀是一个重要的公共卫生和精神卫生问题,严重威胁着人们的身心健康,自杀未遂是自杀的一个重要的预测因素,因此越来越受到重视.本文从自杀未遂的相关因素和心理干预等方面进行综述.     

无抽搐电休克辅助药物治疗伴自杀意念首发抑郁发作患者的临床效果

目的 探讨无抽搐电休克辅助药物治疗伴自杀意念首发抑郁发作患者的临床效果。方法 选取2021年3月—2023年7月我院收治的82例伴自杀意念首发抑郁发作患者为研究对象,采取随机数字表法分为2组,每组41例。其中对照组实施盐酸氟西汀治疗,观察组实施无抽搐电休克联合盐酸氟西汀药物治疗。对比两组认知功能评分、抑郁评分、自杀意念评分及不良反应发生情况。结果 治疗干预1个月后,观察组患者精神认知功能评分高于对照组（P <0.05）;观察组患者抑郁程度评分、自杀意念评分均低于对照组（均P <0.05）;两组不良反应总发生率无统计学差异（P> 0.05）。结论 与单纯的药物治疗相比,对抑郁伴自杀意念首发患者实施无抽搐电休克联合盐酸氟西汀药物治疗,能取得更为理想的治疗效果,积极提升认知功能,缓解其抑郁状况及转变其自杀意念,且无抽搐电休克干预方式较为安全,辅助干预后并未明显增加不良反应发生。     

国防生有自杀意念者心身健康状况及其危险因素的研究

目的探讨国防生有自杀意念者心身健康状况及其影响因素,以便有针对性的采取心理干预,提高其心身健康水平。方法随机整群抽取某高校国防生519名,采用《中国军人心身健康量表》测试心身健康水平,将第63条目＂有想死的念头＂得分等于1分定义为有自杀意念。同时采用《军人心理疾病预测量表》探讨其危险因素。结果国防生自杀意念的发生率为10.3%,除呼吸系、消化系和皮肤因子外,有自杀意念组心身健康量表总分、心理健康因子、躯体健康因子以及其余各因子分均显著高于无自杀意念组（P〈0.05或0.01）;相关分析的结果显示,有自杀意念者的焦虑、抑郁与其成长经历、个性内向、心理防御不良、社会支持缺乏呈显著正相关（r=0.277～0.666,P〈0.05或0.01）,个性内向、心理防御不良、社会支持缺乏、应激源与心身健康总分、心理健康因子分及躯体健康因子分亦呈显著正相关（r=0.292～0.691,P〈0.05或0.01）;经多元逐步回归分析发现,心理防御不良分别进入以有自杀意念者的心身健康总分、心理健康因子、躯体健康因子、焦虑及抑郁因子分为因变量的多元回归方程（P〈0.01）。结论国防生有自杀意念者心身健康状况较差,心理防御不良是自杀意念者心身健康状况的重要影响因素。     

深圳市青少年自杀意念及相关因素分析

目的 了解中学生自杀意念的现状,探讨自杀意念产生的原因,为自杀的早期识别和干预提供理论依据.方法 采用分层整群随机抽样的方法 ,对深圳市14所中学4 950例在校学生,使用自杀行为问卷(SBQ-R-RC)、Beck绝望量表(BHS)、Beck抑郁量表(BDI)、家庭环境量表进行调查.并对自杀意念产生的影响因素进行分析.结果 深圳市青少年自杀意念发生率为34.48%,高中生自杀意念的发生率高于初中生(P＜0.001),女生高于男生(P＜0.001).影响自杀意念的主要因素包括情感表达、矛盾性、独立性、组织性、对未来的感觉和抑郁.结论 青少年自杀意念的发生率较高,特别是女生和高中生,且与社会心理因素密切相关,应当引起学校、家庭和社会的足够重视.     

抑郁症伴自杀意念患者的心理护理

抑郁症是一种常见的心境障碍,抑郁症患者是自杀的高危人群[1]。有研究显示,住院抑郁症患者中自杀问题严重,其中76.3%有过自杀意念[2]。自杀意念是指具有自杀的想法或倾向,不涉及自杀行为,当自杀意念较强时可导致自杀行为[3]。因此,应予以积极的评估及采取有效措施干预。有效的心理护理干预不失为预防抑郁症自杀的措施之一[4]。为探讨心理护理对抑郁症疗效及自杀意念的影响,作者对102例抑郁症伴自     

新入伍士兵自杀意念与自杀行为影响因素调查

目的调查分析影响新入伍士兵自杀意念与自杀行为的主要因素,为自杀预防干预提供依据。方法采取随机整群抽样的方式对5345名官兵使用SCL-90问卷筛查,对筛查阳性者再实施半结构式访谈定性,确认自杀意念形成的主要相关因素。结果存在不同程度自杀意念者共171人,占调查人数的3.1%,其中13人有过对有关实施方式的计划。自杀意念和行为形成的因素中,家庭因素影响较多,主要是家庭关系、家族史、家庭经济等。结论新入伍士兵自杀意念和自杀行为形成过程中,家庭是重要的因素,进行预防性自杀干预时,应对其家庭因素给予充分的关注。     

山西省科技工作者自杀意念调查

<正>近年来由于工作压力而诱发疾病和自杀的人越来越多,其中相当多的是知识员工。自杀意念是自杀未遂和自杀死亡早期的心理活动,是自杀死亡的强危险因素[1]。科技工作者是     

顺德区中学生自杀意念及其影响因素分析

目的 了解本地区中学生自杀意念发生率及其影响因素,为学生心理保健提供依据.方法 采用分层、随机抽取的本地区的1245例中学生为调查对象进行现况调查.自杀意念的评定根据症状自评量表的90个项目中第15项"想结束自己的生命"项.结果 发现有自杀意念者占6.43%.成绩满意度、与父母关系、特殊嗜好、父母之间关系、就读学校类型、家庭主导地位与自杀意念有关联.结论 中学生的自杀意念发生率较高,与多项因素有关,应加强对中学生的心理健康教育.     

大学生自杀意念及行为因素的相关分析

目的 分析在校大学生自杀意念的发生状况,探讨自杀意念及自杀行为的影响因素.方法 采用自制的调查表,以随机整群抽样的方法对520名在校大学生进行调查,并进行单因素和多因素Logistic回归分析.结果 大学生自杀意念的发生率为21.5%,进行过自杀的有15.8%.多因素的Logistic回归模型分析显示:自杀意念发生有关的主要危险因素是:家庭成员的支持、家庭和睦程度、与他人的关系等.结论 自杀意念及自杀行为与其影响因素联系密切,应根据其影响因素予以积极干预,从而减少自杀行为的发生.     

Patterns and correlates of attempted suicide by heroin users over a 3-year period: findings from the Australian treatment outcome study

In order to determine patterns and correlates of attempted suicide amongst heroin users across 3 years, a cohort of 387 heroin users (134 entering maintenance treatment, 134 entering detoxification, 81 entering residential rehabilitation and 38 not entering treatment) were interviewed about suicide attempts at baseline, 12, 24 and 36 months. Across the follow-up period, 11.6% attempted suicide. There were declines in the proportion who attempted suicide each year amongst both males and females and significant declines in Major Depression, suicidal ideation and current suicide plans. Despite this, levels of attempted suicide, suicidal ideation and Major Depression in the cohort remained higher than in the general population. Those who had made a previous suicide attempt were five times more likely to make an attempt across follow-up and there was a strong association between an attempt in any 1 year and increased probability of an attempt in the subsequent year. A quarter of those who reported suicidal ideation at baseline made an attempt across follow-up. At each interview point, current suicidal ideation was strongly associated with increased risk of a suicide attempt in the following year. Independent predictors of a suicide attempt across follow-up were a lifetime suicide history, baseline suicidal ideation, social isolation and the extent of baseline polydrug use. Given the strong predictive value of suicidal ideation and previous attempts, regular brief screening would appear warranted to identify those at greatest risk.     

Attempted suicide among heroin users: 12-month outcomes from the Australian Treatment Outcome Study (ATOS)

A cohort of 495 heroin users, recruited for the Australian Treatment Outcome Study (ATOS), were re-interviewed at 12 months regarding suicide attempts over the follow-up period. The proportion who had attempted suicide in the 12 months since baseline was not significantly different from that reported in the 12 months preceding ATOS enrolment (12.2% versus 9.1%), and attempted suicide did not decline significantly in any of the index treatment groups. Among males, there was no significant reduction in attempted suicide (8.7% versus 8.1%). Among females, however, the proportion reporting an attempt declined significantly from 19.7 to 9.8%. Of those who reported suicidal ideation at baseline, 22.8% made an attempt over the follow-up period, as did 19.0% of those who had major depression. Large, and significant, declines in suicidal ideation (23.1% versus 6.9%) and major depression (25.5% versus 10.9%) occurred over the study period. Independent predictors of a suicide attempt over the follow-up period were: social isolation, having made an attempt in the preceding 12 months, suicidal ideation at baseline, a greater number of treatment episodes and higher levels of baseline polydrug use.     

Suicidal attempts among patients with substance use disorders who present with suicidal ideation

Background and aimsPatients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the specific risk characteristics for suicidal attempts in patients with addiction problems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and to explore the differential characteristics for suicide ideators with and without suicide attempts.MethodsA sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed.MeasurementsInformation concerning socio-demographic characteristics, addiction severity, and psychopathological symptoms was obtained.ResultsIn total, 39.6% of the patients had attempted suicide (95% Confidence Interval: 32.1%–47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction profile and more maladjustment to everyday life than patients with only suicidal ideation. Specifically, three psychopathological variables were related to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium.ConclusionsAccording to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition.     

The association between violence and lifetime suicidal thoughts and behaviors in individuals treated for substance use disorders

Objective

The present study examined the association between lifetime violent behavior and suicidal thoughts and attempts in a national sample of patients seeking substance use disorder (SUD) treatment.

Method

A large national sample of adults entering substance use disorder treatment (N = 6,233) was examined. After describing the correlates of prior suicidal thoughts and attempt(s) in this sample, we examined the association between self-report of lifetime violence and suicidal ideation, a single prior attempt and multiple prior attempts in patients seeking SUD treatment.

Results

In bivariate analyses, individuals with prior violence were more likely to report suicidal ideation, single and multiple suicide attempts than those without prior violence. These associations remained significant after controlling for demographic factors, symptoms of depression, and childhood victimization. In examinations of specific types of violence, more extreme forms of violence (i.e., murder, rape) were most strongly associated with risk of multiple suicide attempts.

Conclusions

Prior violence is consistently associated with greater risk for suicidal thoughts and behaviors in patients seeking SUD treatment. Treatment providers should be aware that those patients with some of the greatest violence in their past are also those at elevated risk for harm to themselves.     

The association between partner and non-partner aggression and suicidal ideation in patients seeking substance use disorder treatment

Objective

The present study was designed to examine the relationship between prior partner and non-partner aggression and suicidal ideation in patients seeking drug and alcohol treatment.

Method

Patients entering drug and alcohol treatment (n = 488) were screened for prior partner and non-partner aggression as well as recent suicidal thoughts. We examined the association between aggression and suicidal ideation in bivariate and multivariate models.

Results

Within the past two weeks, 33% (159/488) of the sample reported suicidal ideation. In bivariate analyses, neither psychological nor physical aggression towards a non-partner was related to suicidal ideation. Partner psychological aggression was related to suicidal ideation in bivariate but not multivariate analyses. Physical aggression towards a partner was consistently related to higher rates of suicidal ideation even after controlling for other known risk factors (OR = 1.8; CI = 1.1–2.7). Mediational analyses indicate that this relationship was no longer significant after accounting for current negative affect.

Conclusion

Suicidal ideation is common in patients seeking drug and alcohol treatment and particularly likely in those who report prior aggression towards a partner.     

Predicting Suicide Ideation for Substance Users: The Role of Self-Esteem,Abstinence, and Attendance at 12-Step Meetings

This study tested if a three-way interaction between gender, abstinence, and self-esteem could predict the occurrence of suicidal thoughts in a sample of drug users who are one year post-treatment. It was expected that those who resolved their drug and alcohol problems and had higher self-esteem would have a lower risk of suicide ideation than those who had resolved their drug and alcohol problems (e.g. were abstinent) and had lower self-esteem, and that this effect would be stronger for women than men. Using a 3-step hierarchical logistic regression, results indicated a significant 2-way interaction between self-esteem and abstinence in the predicted direction, and no effect for gender. However, it was also found that those who had lower levels of self-esteem, regardless of abstinence or continued use, had virtually identical odds of suicidal ideation. Further, increased frequency of attendance at AA/NA meetings also predicted a higher risk of suicide ideation. This suggests that careful assessment of depression symptoms or suicidal ideation for drug users seeking assistance be completed before automatically urging attendance at 12-step meetings. Implications for clinical work with clients are presented.     

Relationship between a history of a suicide attempt and treatment outcomes in patients with depression

This study aimed to investigate the sociodemographic and clinical correlates of a history of a suicide attempt in people with depression and their relationship with treatment outcomes and subsequent suicidal ideation and deliberate self-harm. Patients with depressive disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were recruited from 18 hospitals across South Korea. Data on sociodemographic and clinical characteristics were obtained, and scales assessing depression, anxiety, and general functioning were administered during the first 12 weeks of antidepressant treatment. Baseline characteristics, responses to treatment, and suicidal ideation/deliberate self-harm during the follow-up period were compared according to a reported history or not of a suicide attempt. In a total of 723 participants, 143 (19.8%) with a history of a suicide attempt had an earlier age of onset, longer duration of illness, and a greater number of depressive episodes. Levels of depression and anxiety were significantly higher at baseline in this group who also experienced significantly lower remission and response rates, as well as longer time to remission. The case group was more likely to experience new suicidal ideation and carry out a deliberate self-harm act during the 12-week treatment period. In conclusion, a history of a suicide attempt in a Korean population with depression was characterized by more severe psychopathology, poorer treatment outcomes, and higher subsequent suicidal ideation and self-harm. Therefore, more intensive and longer-term treatment with particular ongoing clinical attention to risk is indicated in patients with these distinct, chronic, and severe forms of depression and ongoing high suicide risk.