住院精神病患者自杀相关因素分析

目的探讨导致住院精神病患者自杀的相关因素,为预防自杀提供依据.方法对25例住院期间发生自杀者的临床资料进行回顾性分析.结果自杀以精神分裂症、抑郁症多见;假出院发生自杀死亡率较高.强制入院、恢复期抑郁、缺乏亲情关怀、残留症状等与自杀有相关性.结论住院精神病患者的自杀行为与多因素有关,应引起医护人员的高度重视.     

精神病患者住院期间自杀行为20例分析

目的 探讨精神病患者在住院期间自杀的相关风险因素．制定相应预防干预措施。方法 对我院20例有明显自杀行为的住院精神病患者的临床资料进行回顾性调查分析。结果 20例均为精神分裂症患者。自杀方式：自缢12例次．跳楼7例次，割脉2例次，吞食异物1例次。其中自缢死亡4例．跳楼死亡1例．跳楼重伤2例．轻伤1例。自杀原因：受幻觉、妄想支配6例，抑郁自罪3例，不安心住院8例．不明原因3例。有阳性家族史4例。既往曾有自杀言行者12例。结论 对有自杀言行的住院患者，应注意分析风险因素，制定切实有效的防范措施。     

不同年代住院精神病患者自杀的相关因素及护理策略

目的：了解不同年代住院精神病患者自杀的相关因素,以探索有效的预防精神病患者自杀的护理策略。方法：回顾性调查1961年～2000年32例不同年代住院精神病患者的自杀原因,并采用Logistic回归分析患者自杀的危险因素。结果：各种精神疾病患者自杀率差异无显著性（P〉0.05）;自杀与精神病理症状有关;既往有自杀史、负性生活事件、家庭成员有自杀史、病情严重和社会支持不足,是住院精神病患者发生自杀的危险因素;治疗依从性好是患者自杀的保护因素;各年代自杀率呈下降的趋势（P〈0.01）。结论：做好风险评估和实施预见性护理,控制病情,加强监护管理等综合护理措施,有利于预防住院精神病患者自杀行为。     

不同年代住院精神病患者自杀的相关因素及护理策略

目的：了解不同年代住院精神病患者自杀的相关因素,以探索有效的预防精神病患者自杀的护理策略。方法：回顾性调查1961年～2000年32例不同年代住院精神病患者的自杀原因,并采用Logistic回归分析患者自杀的危险因素。结果：各种精神疾病患者自杀率差异无显著性（P〉0.05）;自杀与精神病理症状有关;既往有自杀史、负性生活事件、家庭成员有自杀史、病情严重和社会支持不足,是住院精神病患者发生自杀的危险因素;治疗依从性好是患者自杀的保护因素;各年代自杀率呈下降的趋势（P〈0.01）。结论：做好风险评估和实施预见性护理,控制病情,加强监护管理等综合护理措施,有利于预防住院精神病患者自杀行为。     

住院抑郁症病人自杀未遂情况调查

[目的]探讨住院抑郁症病人自杀发生率、性别差异、自杀因素及护理干预对策。[方法]利用问卷调查表对150例自杀未遂的抑郁症病人自杀相关资料进行回顾性调查。[结果]住院抑郁症病人出现自杀意念、自杀意图、自杀行为较高;女性病人自杀行为明显多于男性,但男性自杀行为的后果更为严重;精神病家族史、自杀家族史、家庭环境等均与自杀行为密切相关。[结论]住院抑郁症病人存在较多的自杀问题,特别是病程长、多次住院、具有精神病家族史和自杀家族史者是自杀预防的重点人群。     

癌症患者自杀行为原因分析与护理对策

目的探讨住院癌症患者发生自杀行为的相关因素，制定有针对性的心理护理及安全管理措施。方法按时间顺序逐个调查2004年7月-2007年6月在东南大学附属中大医院肿瘤科住院期间发生自杀行为的29例患者临床资料，进行自杀行为分类，并分析自杀原因，在此基础上采取相应心理护理、安全管理措施，比较针对性护理措施后的效果。结果29例发生自杀行为的患者中，自杀成功3例，占10．3％，自杀未遂8例，占27．6％，有自杀准备4例，占13．8％，有自杀计划2例，占6．9％，有自杀意念12例，占41．4％。发生自杀行为的原因与心理障碍、情感支持缺乏、疼痛、生活质量下降和经济负担过重等有关。通过有针对性的干预，自杀行为人数逐渐下降（P〈0．05）。结论加强对患者的心理疏导，强化病区护理安全管理，增强医护人员法律意识，能使住院癌症患者自杀行为减少。     

精神病患者自杀行为临床特征分析及预防措施

目的：探讨精神病患者自杀行为的临床特征,为制定临床预防措施提供依据。方法对30例有自杀行为的精神病患者的临床资料进行回顾分析。结果本组自杀者以抑郁症（60．0％）、精神分裂症（36．7％）居多,自杀行为多发生于凌晨1时-2时（50．0％）,自杀前主要表现为焦虑、绝望、痛苦、抑郁等,自杀地点多发生在卫生间、病房、窗户、床头。结论精神病患者自杀行为具有一定的规律性,护理人员应加强安全管理,积极采取综合预防措施,杜绝或减少自杀的发生。     

预见性护理对伴有抑郁症状的精神障碍患者自杀风险的影响

目的：探讨预见性护理在有抑郁症状的精神障碍患者护理中减少自杀风险的应用效果。方法选取2012年1-12月收治的有抑郁症状的精神病患者63例入对照组,2013年1-12月的有抑郁症状的精神病患者68例入干预组,对照组实行常规护理,干预组在此基础上实行预见性护理,比较两组患者的自杀行为发生情况。结果干预组自伤2例,自缢未遂1例,发生自杀行为共3例,自杀风险行为发生率4．41％,对照组自伤5例,自缢未遂2例,发生自杀行为共7例,自杀风险行为发生率11．11％,两组比较差异有统计学意义（χ2＝2．125,P＜0．05）。结论实施预见性护理可将有抑郁症状的精神病患者发生自杀行为的几率降低,能够有效降低护理风险。     

精神病患者住院前后自杀行为分析及护理干预

目的:分析精神病患者自杀的潜在危险因素,探讨如何从护理角度进一步预防住院精神病患者的自杀行为。方法:对2004年1月至2008年12月住院且在住院前后有自杀史的258例患者的临床资料进行回顾性分析。结果:258例患者住院前的自杀方式以服毒、自缢、割腕、跳楼居多,住院后的自杀方式以自缢居多;出院后自杀成功7例,住院期间自杀成功1例。结论:住院精神病患者自杀具有一定的规律性,通过增强护理防范意识,及早对患者实施有针对性的护理干预,可预防、降低患者的自杀成功率。     

半开放式管理下精神病患者死亡原因分析及对策

目的 寻找半开放式管理下精神病房中临床护理的工作缺陷，为改进护理工作，减少意外事件的发生提出对策。方法 回顾分析1988年1月～2003年7月本中心7786例住院精神病患者中16例死亡患者的致死原因及护理相关因素，并与国内相关资料作比较。结果 半开放式精神病房患者死亡率为0．21％，比国内报道的封闭式精神病房住院患者死亡率0．40％～1．17％低。其中无1例死于感染性疾病；自杀37．50％、猝死31．25％；12例死于非正常办公时间。结论 精神病患者的死亡具备隐蔽性、突发性．提出从建筑物设计、病房管理、护士素质3方面加强管理和改进，以提高护理质量，有效减少住院精神病患者的死亡率。     

不同性别双相情感障碍患者发生自杀行为的临床特征比较研究

目的:研究双相情感障碍患者自杀行为相关因素的性别差异。方法:依据ICD-10诊断标准入组有自杀行为的双相情感障碍患者1739例和无自杀行为的双相情感障碍患者3713例,进行不同性别间各项目的比较分析,通过Logistic回归分析男、女性双相情感障碍患者自杀行为相关的危险因素。结果:男、女性伴自杀行为双相情感障碍患者在年龄、婚姻状况、职业、吸烟史、饮酒史、重大精神创伤史、入院次数等方面差异有统计学意义(P<0.05)。男性伴自杀行为患者较无自杀行为者年龄更大、已婚者更多、独生子女较少、较多家族自杀史、家族精神异常史、既往自杀史,差异有统计学意义(P<0.01)。女性伴自杀行为者较无自杀行为者年龄更大、较多饮酒史、重大精神创伤史、家族自杀史、既往自杀史,差异有统计学意义(P<0.05)。Logistic回归分析显示,女性患者的重大精神创伤、家族自杀史、既往自杀史与发生自杀行为相关(P<0.05)。男性患者的既往有自杀史与发生自杀行为相关(P<0.01)。结论:男、女性双相情感障碍患者的自杀行为危险因素存在一定差异,区别化对待其危险因素对预防自杀有重要意义。     

抑郁症患者自杀行为与自杀意念及领悟社会支持相关性研究

目的：探讨抑郁症患者自杀行为与自杀意念、领悟社会支持的相关性。方法选取59例惠爱医院住院的抑郁症患者为研究对象。根据近3个月是否有自杀行为,将患者归入自杀行为组（n＝28）和非自杀行为组（n＝31）;采用自杀意念自评量表、领悟社会支持量表及自编一般资料调查表对两组患者进行评估。结果伴自杀行为组自杀意念较未伴自杀行为组强烈（t＝3．03,P＜0．05）,领悟社会支持度低于未伴自杀行为组（t＝2．99,P＜0．05）。中介效应分析表明,领悟社会支持在自杀意念与自杀行为间发挥完全中介作用,自杀意念会削弱抑郁症患者的领悟社会支持,导致自杀风险增加。结论领悟社会支持在自杀意念与自杀行为间发挥重要中介作用,故在自杀干预中既要丰富社会支持资源和支持方式,又要引导患者主动利用,减少自杀行为的发生。     

开放病房抑郁症自杀行为分析与对策

目的：探讨开放心理病房抑郁症自杀行为的对策。方法：对2006年10月8日至2008年4月30日收住的195例抑郁症患者进行回顾性分析。结果：经治疗和干预后自杀意念明显下降,而自杀未遂在治疗好转时有所增加,治疗4周时自杀意念和自杀未遂明显下降：入院前与第一周比较自杀意念没有统计学差异,而自杀未遂则有统计学差异,和第二周及第四周比较自杀意念、自杀未遂有统计学差异。结论：开放式心理病房采取综合的治疗和护理措施可有效地预防抑郁症患者的自杀行为。     

Suicidal behavior in psychiatric emergency room patients

BACKGROUND: Psychiatric emergency room (ER) patients are thought to be at increased risk of suicide. The prevalence and characteristics of suicidal behavior in a recent sample of patients who came to the ER for psychiatric evaluation were examined. METHODS: Charts of 311 consecutive psychiatric ER patients were reviewed. Suicidal behavior was considered present if current suicidal ideation or attempts within 24 hours of or during the emergency evaluation were noted in the chart. RESULTS: Suicidal behavior was present in 38% of the psychiatric ER patients. Younger age, white race, affective disorders in female patients, and substance abuse disorders in male patients were features of the suicidal group. Sex of the patient was not associated with suicidal behavior. CONCLUSIONS: Suicidal behavior is prevalent in the psychiatric ER. Effective suicide prevention in this setting will hinge on finding more specific risk factors.     

Interpersonal problem solving and parasuicide

This study examined the relationship between interpersonal problem solving and suicidal behavior among psychiatric patients. Subjects were 123 psychiatric inpatients, admitted for current parasuicide, serious suicide ideation, or non-suicide-related complaints. A group of 16 orthopedic surgery patients was included to control for hospitalization trauma and current stress. All subjects completed a revised version of the Means-End Problem Solving Procedure, the Rathus Assertiveness Schedule, and a suicide expectancy measure. Psychiatric patients scored lower than the medical control group on the assertive schedule, but no differences were noted as a function of suicidal behavior status. Psychiatric patients expected suicide to solve problems more than did controls. Suicidal patients had higher expectancies than did nonsuicidal patients. Active interpersonal problem solving did not distinguish suicidal and nonsuicidal psychiatric patients but did separate parasuicides from suicide ideators. Among patients without a parasuicide history, less active and greater passive problem solving discriminated first-time parasuicides from suicide ideators and nonsuicidals. Results suggest that assertion deficits may characterize the psychiatric population in general, but suicidal behavior within psychiatric patients may be related to lower active problem solving.This research was supported by National Institute of Mental Health Grant NIMH No. 5 ROI MH34486-03 to Marsha M. Linehan.     

An Examination of Optimism/Pessimism and Suicide Risk in Primary Care Patients: Does Belief in a Changeable Future Make a Difference?

An integrative model involving optimism/pessimism and future orientation as predictors of suicide risk (viz., depressive symptoms and suicidal behavior) was tested in a sample of adult, primary care patients. Beyond the additive influence of the two predictors of suicide risk, optimism/pessimism and future orientation were also hypothesized to interact together to exacerbate suicide risk. Results indicated that optimism/pessimism was a robust predictor of suicide risk in adults. Future orientation was found to add significant incremental validity to the prediction of depressive symptoms, but not of suicidal behavior. Noteworthy, the optimism/pessimism × future orientation interaction was found to significantly augment the prediction of both depressive symptoms and suicidal behavior. Implications for therapeutic enhancement of future-oriented constructs in the treatment of suicidal individuals are discussed.     

精神分裂症急性期伴自杀行为35例临床特征分析及护理

目的:调查精神分裂症急性期伴自杀行为患者的临床特征及护理方法.方法:分析35例急性期精神分裂症伴自杀行为患者的临床特征,研究经过自杀干预护理措施治疗后的成效.将没有发生自杀行为倾向的154例住院患者作为对照组进行比较.结果:精神分裂症急性期自杀发生率18.51%,常发生于女性、年龄较大、病程短和发病年龄较晚的患者;经过自杀干预护理措施治疗后自杀行为发生率明显降低,第2周时社会兴趣、迟缓、抑郁和精神症状因子明显改善,第8周时多项因子明显改善,与对照组比较差异有统计学意义(P＜0.05).结论:及时发现急性期精神分裂症伴自杀行为患者的临床特征,实施正确的护理干预有助于减少自杀行为的发生.     

双相情感障碍伴自杀行为的流行病学分析

目的分析双相情感障碍伴自杀行为患者的流行病学特征,提高对其诊治水平。方法选取2016年5月至2018年5月洛阳市第五人民医院(太康路院区)精神科收治的186例双相情感障碍患者,年龄(43.15±5.66)岁,年龄范围为23~55岁,对患者流行病学特征进行统计,并通过logistic回归分析与各种危险因素之间的关系。结果根据有无自杀行为将患者分为有自杀行为组(n=96)和无自杀行为组(n=90),两组患者性别、婚姻状况、人际关系、是否为独生子女方面比较,差异无统计学意义(P>0.05);两组患者年龄、吸烟史、精神异常史、饮酒史方面比较,差异有统计学意义(P<0.05)。男性有自杀行为组与男性无自杀行为组患者年龄、婚姻状况、吸烟史、人际关系、是否为独生子方面比较,差异无统计学意义(P>0.05);男性有自杀行为组与男性无自杀行为组患者精神异常史、是否饮酒、家族自杀史、既往自杀史比较,差异有统计学意义(P<0.05)。女性有自杀行为组与女性无自杀行为组患者婚姻状况、人际关系、是否为独生子女方面比较,差异无统计学意义(P>0.05);女性有自杀行为组与女性无自杀行为组患者年龄、吸烟史、精神异常史、饮酒史、家族自杀史、既往自杀史方面比较,差异有统计学意义(P<0.05)。logistic回归分析显示,女性、年龄大、重大精神创伤、既往自杀史与双相情感障碍伴自杀行为均呈正相关。结论女性、年龄大、有重大精神创伤、有自杀家族史、既往自杀史等都可能是双相情感障碍伴自杀行为患者的危险因素临床上应给予高度重视并及早采取干预措施,以免延误最佳治疗时机。     

Assessing suicide risk in stroke patients: review of two cases

Poststroke depression can be accompanied by suicidal ideation, yet reports of suicide among stroke patients are rare. When untreated, depression can become prolonged and severe. Risk factors for suicide include depression, severe insomnia, chronic illness, and organic brain syndrome. Early clinical assessment of suicide risk factors is essential in the rehabilitation setting. Two patients who developed mood disturbances in the acute poststroke period and eventually committed suicide are presented. Neither patient openly expressed suicidal thoughts to staff or family members. Retrospective analysis of medical records was compared to established suicide risk factors reported in the medical literature. Indirect verbal cues and nonverbal behavior patterns indicating potential suicide risk may have been present. Strategies for evaluation and management of suicidal behavior are discussed. These cases emphasize the need for early assessment of suicide risk by the entire rehabilitation team.     

Stress and knowledge of suicidal others as factors in suicidal behavior of high school adolescents.

The purpose of this study was to explore adolescent beliefs concerning the causes of adolescent suicide and to examine the influence that suicidal others have on adolescents' behavior. The researcher asked the following questions: Do students reporting suicidal behavior and those reporting no suicidal behavior give different causes for suicide? Do males and females give different causes for suicide? Does knowing someone who attempted or committed suicide affect an adolescent's suicidal behavior? The population sample was 473 eleventh- and twelfth-grade students from a suburban public school district near a large metropolitan area in the northeastern United States who completed self-report measures including an open-ended question measuring suicidal causality and a background questionnaire. Data were analyzed using cross-tabulations to compare suicidal and nonsuicidal adolescents. Specific tests included the Fisher's Exact Test (two-tailed) and chi-square. The findings showed that, of the high school students studied, 23% reported self-hurt behavior and 6.7% reported suicide attempts. A theme of "too much pressure" was reported by 40% of the adolescents as a cause of suicide. Males and females reported statistically significant divergent views regarding the causes of adolescent suicide. Other findings showed highly significant differences between the suicidal and nonsuicidal adolescents when they knew someone who attempted or committed suicide. This information suggests that approximately one in three adolescents who report self-hurt behavior may attempt suicide and that counseling needs to address the findings that males and females perceive the causes of suicide differently and therefore may respond to treatment programs differently. The importance of peer identification with others who attempt or commit suicidal acts cannot be underestimated.