2007年利津县部分高中生自杀意念及家庭相关因素分析

[目的]了解高中生自杀意念及家庭相关因素,以便为高中生的心理卫生干预提供依据。[方法]2007年11月,在利津县1所中学,抽取高中学生872名,调查过去1个月内自杀意念发生情况及其家庭相关因素。[结果]在872名学生中,完成问卷调查834人,应答率为95.64%。在834人中,过去1月内有自杀意念者61人(想过1次者35名、想过2~3次者18名、天天想者8名),发生率为7.39%。过去1个月内自杀意念发生率,男生为5.99%,女生为8.75%(P>0.05);一年级为6.87%,二年级为7.06%,三年级为8.03%(P>0.05)。61名有自杀意念者中,12名(19.67%)与父母谈论过自杀想法,34名(55.73%)与朋友谈论过自杀想法。多因素非条件Logistic回归分析结果,对自己心理健康状况评价(OR为0.676)、父母婚姻状况(OR为1.510)是影响高中生发生自杀意念的因素。[结论]高中生过去1月内自杀意念发生率较高。对自己的心理健康状况评价差、父母不和睦的高中生容易发生自杀意念。     

许昌市城乡居民自杀意念及其影响因素分析

目的了解一般人群自杀意念及其影响因素,为制定自杀干预措施提供依据。方法采用统一他评的方式,问卷使用北京回龙观医院即北京心理危机研究与干预中心提供的《自杀态度与心理健康状况问卷》(社区版-Ⅵ)。分别随机抽取魏都区和许昌县城乡居民进行问卷调查,了解自杀意念的发生及其影响因素。结果共回收合格调查问卷1 002份,其中城市居民488人,占48.70%,农村514人,占51.30%。年龄为18～90岁,平均45.9岁。其中男性536人,占53.49%,女性466人,占46.51%;2人有过自杀或自伤行为,近一年共有9人有时或经常想过自杀或故意伤害自己,其中4人为城市社区居民,5人为农村居民。自杀意念发生率为898.20/10万。多元逐步回归分析结果显示:收入来源、读书年限、最近30 d失眠的天数及最近30 d因躯体疾病或伤害而难以从事日常活动或学习的天数有统计学意义(F1=5.30,p=0.00,F2=1.79,p=0.02,F3=5.41,p=0.00,F4=7.50,P=0.00)。结论重点关注低收入、没有固定收入来源和睡眠质量差以及患有慢性疾病甚至导致伤残的人群。     

北京高校大学生自杀意念及影响因素研究

目的了解北京高校大学生自杀意念及影响因素,为高校大学生自杀干预体系的建立提供理论依据。方法采用Beck自杀意念量表,通过分层整群随机抽样方法,于2011年11—12月对北京地区6所高校的1186名在校大学生的自杀意念及影响因素进行问卷调查。结果在1186名调查对象中,有自杀意念者307人,自杀意念平均为（9．61±6．48）分,占25．89％。Logistic回归分析结果表明,专业类别、专业满意度、独生子女状况、家庭和睦状况、身体健康状况,以及学校是否设有心理健康服务中心是大学生有无自杀意念的影响因素。表现为文史类专业的大学生有自杀意念的学生所占的比例是艺体类的2．08倍,独生子女中有自杀意念的比值是非独生子女的1．40倍,而身体健康状况较好、家庭和睦以及学校设立心理健康服务中心的大学生有自杀意念的比例分别是身体健康状况不好、家庭不和睦及学校未设立心理健康服务中心的大学生的0．68、0．49及0．59倍。结论北京地区高校大学生的自杀意念较高,高校应加强自杀预警和干预体系,降低自杀意念,预防大学生自杀行为的发生。     

四川省2家医院梅毒感染者自杀意念状况及相关因素分析

目的探讨梅毒感染者自杀意念状况并分析其相关因素。方法选取一般资料调查表、自杀意念评定量表(SIOSS)、自尊量表(SES)、社会影响量表(SIS),于2018年1—12月对四川省2家医院住院的140例梅毒感染者进行横断面调查。结果梅毒感染者自杀意念总评分为8.39±2.59。不同文化程度、婚姻状况、职业和梅毒类型间,自杀意念评分比较,差异有统计学意义(t/F=2.602、3.994、2.473、2.657,均P<0.05)。多元线性回归显示,自尊评分、病耻感评分、婚姻状况、梅毒类型对梅毒感染者的自杀意念总评分有影响(t=2.903、4.086、2.870、2.316,均P<0.05)。可解释回归方程总变异的22.4%。结论梅毒感染者自杀意念普遍较高,应引起门诊医务人员的重视。针对病耻感强、自尊水平低、未婚、显性梅毒感染者,应采取有针对性的指导策略,以有效缓解其消极情绪,从而避免自杀行为的出现。     

军人自杀意念及影响因素分析

目的了解军人自杀意念的现况,分析影响军人自杀意念的相关因素,为部队制定相关措施提供依据。方法通过多阶段随机整群抽样方法,抽取军队现役官兵14 000名,采用世界卫生组织复合性国际诊断交谈表(C ID I3.0)中文版和自编军人一般情况调查表进行面对面的访谈。结果11 527名受访者完成了访谈,应答率为82.33%,近1年来有过认真考虑自杀的为174人,占1.51%;有过详细的自杀计划为25人,占0.22%,采取过自杀行动的26人,占0.23%;多因素Logistic回归分析显示,军人自杀意念的相关影响因素有精神障碍史、兵源来自城市、幼年非亲生父母抚养等。结论军人自杀意念的比例明显低于一般同龄人群。     

我国大学生自杀意念的影响因素

本文通过对我国大学生自杀意念相关文献的梳理,发现大学生产生自杀意念的影响因素分为危险因素和保护因素,其中本文危险因素主要包括女性、自杀接触史或自杀/自伤经历、压力或压力性生活事件、心理健康问题、不良个性特征或消极人格特质、负性生活经历、非理性的自杀态度、不良成长环境、满意感/意义感或幸福感缺失、抗挫折心理能力不足等,而保护因素主要包括生存理由、积极心理品质、社会支持、健康生活方式等。大学生自杀意念的产生受到多种因素的影响,其预防或防范需要个人、家庭、学校和社会的共同努力。     

有自杀意念大学生心理特征分析

目的了解有自杀意念大学生的心理健康状况、个性、自卑感及其影响因素,为提出相应的预防对策提供依据。方法采用症状自评量表(SCL-90)、艾森克个性问卷(EPQ)、自卑感量表(FIS)、自杀态度问卷(QSA),对分层整群抽取的河南科技学院765名大学生进行调查,筛选自杀意念学生,并采用回归分析方法研究自杀意念与各种心理特征的关系。结果大学生自杀意念报告率为15.9%,性别、本专科差异均无统计学意义(P值均>0.05)。有自杀意念者SCL-90总分及10个因子得分均高于无自杀意念者;有自杀意念的内外向(E)和掩饰性(L)得分较低,神经质(N)和精神质(P)得分较高;自杀意念者的自卑总分、自我价值、社交自信、体能自信分数高于无自杀意念组;有自杀意念者在对自杀行为性质的认识及对安乐死态度方面得分低于无自杀意念者,差异均有统计学意义(P值均<0.05)。自杀意念与心理健康、自卑感、N分、P分正相关,与E分、L分负相关。结论有自杀意念大学生心理健康水平较差,人格缺陷明显,自卑感强,对自杀持较宽容态度。应关注睡眠差,有精神质、神经质特征,以及对自杀行为持认可态度的人。     

武汉市郊区居民自杀意念严重程度的影响因素研究

目的描述武汉市郊区居民自杀意念流行特征,探讨自杀意念严重程度的影响因素,为自杀干预提供信息和技术支持。方法调查对象为15周岁及以上且最近6个月一半以上的时间居住本地区的郊区居民,采取户内抽样的方法,入户一对一调查。结果轻度、中度和重度自杀意念发生率分别为33．08％、5．85％和4．83％;性别（t=-2．21,P=0．0276）、读书年限（t=-2．09,P=0．0376）、家庭经济状况（t=2．85,P=0．0046）、抑郁状况（t=-2．62,P=0．0092）、生活质量（t=12．24,P〈0．0001）。以上诸因素对郊区居民自杀意念严重程度有显著影响。结论女性是重点,从医学防治的角度讲,需要加强精神卫生专业人员建设,从社会防治的角度讲,需要采取文化教育、经济建设和生活质量的提升等综合措施。     

青少年学生自杀意念影响因素预测作用分析

目的了解绍兴市青少年学生自杀意念的发生率,验证心理社会人口统计学因素对自杀意念的预测作用。方法采取整群抽样方法,抽取绍兴市1所大学、2所高中、2所初中的学生2 334名作为研究对象,在基线调查的基础上,继续前瞻性地进行3次随访调查,完成1 a的队列研究。采用自填式问卷调查的方式收集研究对象的人口统计学变量、自杀意念等,同时使用亚健康多维评定问卷、焦虑自评量表、抑郁自评量表评价青少年的心理卫生状况。统计分析方法包括χ2检验、多因素Logistic回归分析等。结果基线资料显示,青少年自杀意念的发生率与身心亚健康状况、学段、学校负担、脾气、吃多了感觉内疚、不健康减肥行为、醉酒、焦虑状况和抑郁状况存在统计学关联。随访资料显示,身心亚健康状况、学段、饮酒、焦虑状况对青少年自杀意念具有独立的预测作用。结论通过观察自杀意念的预测变量而识别高危人群,对预防青少年自杀企图的产生、降低青少年自杀发生率意义重大。     

高校家庭经济困难新生自杀意念及其影响因素分析

探讨高校家庭经济困难新生自杀意念现状及其影响因素,为高校心理健康教育工作提供理论依据.方法 随机抽取广州市2所高校新生10 924名,采用自杀意念问卷、大学生人格问卷(UPI)、抑郁自评量表(SDS)、简明应对方式问卷和社会支持量表进行测试,并对其中3 057名家庭经济困难新生进行分析.结果 家庭经济困难新生自杀意念发生率为7.75%,非经济困难生为4.74%,差异有统计学意义(P<0.01);家庭经济困难新生自杀意念绝望、乐观和睡眠3个因子及总分均高于非经济困难学生(P值均<0.01),UPI,SDS,社会支持和消极应对方式得分高于非经济困难生(P值均<0.01);女生的绝望、睡眠以及自杀意念总分高于男生(P值均<0.05);UPI,SDS以及消极应对、主观支持、客观支持和对支持的利用度对自杀意念回归效应显著(P值均<0.05).结论 家庭经济困难新生自杀意念高于非经济困难生.应从影响家庭经济困难学生自杀意念的因素人手加强心理健康教育工作.     

Creating a database to facilitate multilevel analyses of mental health determinants and outcomes in rural and remote areas

Objective:  The lack of consistent findings regarding comparisons of mental health between rural and urban areas has been attributed in part to methodological shortcomings, including poor conceptualisation of 'rurality'. To address the diversity of rural and remote communities, an interdisciplinary collaboration sought to establish a database incorporating a range of domains hypothesised to be major influences on the mental health of individuals, families and communities.
Design:  The database domains included health (physical and mental), health service utilisation, sociodemographic characteristics, climate patterns, agricultural activity and primary industry. Important steps in the development of the database were addressing issues related to ethics, ownership, accessing data sources, sustainability of the database and integration of differing outcomes sought by the collaborators.
Results:  The paper describes the database while an illustrative example of analysis demonstrates its application. The potential for multilevel analyses between the database and other datasets is discussed as well as challenges for the future development of this valuable resource for rural mental health research.
Conclusion:  The Centre for Rural and Remote Mental Health database will be a valuable resource for rural mental health research.     

Mental health and suicidal ideation among Chinese women who have sex with men who have sex with men (MSM)

ABSTRACT

In China, men who have sex with men (MSM) are the fastest growing population at risk for HIV. They face social stigma due to both MSM behavior and HIV. In addition, concern has been raised about the mental health of wives of MSM. In this cross-sectional study, the authors examine the mental health status of a sample of 135 of these women. Participants completed an Internet-administered questionnaire in Xi’an from April to June, 2012. Most were unaware at the time of marriage that their husbands were MSM. Physical abuse was frequently reported; depressive symptom and mental health (Symptom Checklist, SCL–90) scores were significantly higher than those of the general Chinese adult female population. A majority (59.8%) of women reported suicidal thoughts after discovering their husbands’ MSM behavior; about 10% had attempted suicide. Multiple logistic regression revealed that women’s experience with anal sex was associated with 7.8 times (95% CI: 1.3–65.9) greater odds of suicidal ideation. Also, women who demonstrated mental symptoms on the SCL–90 had 2.3 times (95% CI: 1.04–5.2) the odds of suicidal ideation. These results suggest that wives of MSM have a significant need for mental health care, suicide prevention, HIV education, and social support.     

自杀意念新生心理健康状况及影响因素分析

目的 掌握大学新生有自杀意念者心理健康状况及影响因素,并提出预防对策.方法 采用大学生人格问卷(UPI)、症状自评量表(SCL-90)对河南科技学院2009级3 850名新生进行问卷调查,筛查有自杀意念学生162人,采用回归分析法分析自杀意念与心理健康因素的关系.结果 自杀意念检出率为4.21%,存在生源(χ²=12.36,P=0.000)、学科(χ²=18.4,P=0.002)差异,无性别差异(χ²=0.299,P=0.583);UPI、SCL-90量表中,有自杀意念者总分、因子均分高于无自杀意念者(P<0.01);回归分析显示,对自杀意念有影响的因素按OR值大小排列依次是:抑郁(17.238)、其他(2.453)、敌对(1.713)、偏执(1.647)、性别(0.676)、人际敏感(0.449)、强迫(0.412).结论 有自杀意念的新生心理健康水平较低,心境低落、睡眠障碍、饮食异常、敌对、偏执是自杀高风险因素,重点关注对口生、农科类学生,加强心理健康教育,构建心理危机干预体系.     

Mental health training and development needs of community agency staff

Emphasis has long been placed in UK national policy on providing 'seamless' mental health services to meet both the health and social care needs of service users. While attention has been paid to the training required by specialist mental health and primary care staff in order to achieve this, the needs of other community agency staff have received less attention. The present article describes a study designed to identify the training needs of staff working within a broad range of agencies. Focus group discussions were used to explore participants' experiences of mental health problems amongst clients, their confidence in dealing with these, current sources of support and perceived training needs. The results indicate that participants in all agencies routinely encountered a range of problems. Colleagues were the main source of support, followed by line managers, but supervision structures and wider organisational support were lacking in some cases. Joint working with specialist mental health services was almost universally problematic and all groups identified a range of training needs. On the basis of the results, the present authors put forward suggestions as to how these needs might be met.     

社区心理卫生服务人员心理疾病识别能力分析

目的 了解社区心理卫生服务人员对常见心理疾病的识别能力。方法 采用随机整群抽样方法,抽取北京市朝阳区、哈尔滨市南岗区和克拉玛依市克拉玛依区的165名心理卫生服务人员进行问卷调查。结果 北京市朝阳区心理卫生服务人员对抑郁症的正确识别率为79.6%（39/49）,高于克拉玛依市的43.6%（24/55）和哈尔滨市的60.7%（37/61）,差异均有统计学意义（P<0.05）;对焦虑症的正确识别率为77.6%（38/49）,高于克拉玛依市的25.5%（14/55）和哈尔滨市的16.4%（10/61）,差异均有统计学意义（P<0.001）;对精神分裂症的正确识别率为93.9%（46/49）,高于哈尔滨市的50.8%（31/61）和克拉玛依市的43.6%（24/55）,差异均有统计学意义（P<0.001）;对躁狂症的正确识别率为77.6%（38/49）,高于哈尔滨市的45.9%（28/61）和克拉玛依市的47.3%（26/55）,差异均有统计学意义（P<0.001）;对强迫症的正确识别率北京市为98.0%（48/49）,哈尔滨市为47.5%（29/61）,克拉玛依市为65.5%（36/55）,差异均有统计学意义（P<0.05）。结论 3个地区社区心理卫生服务人员对心理疾病的识别能力有待提高,应进一步提高服务人员的理论知识和业务水平。     

医学院学生自杀意念及危险因素分析

目的 了解医学院学生自杀意念发生率.并分析自杀意念的危险因素.方法 应用Beck抑郁问卷、Beck焦虑量表、Beck无望感量表、青少年健康相关行为问卷、青少年生活事件量表、简易应对方式问卷、自杀态度问卷、人格诊断问卷(第4版),对华北某医学院1～3年级2 493名本科生进行现场调查,了解自杀意念发生率.采用单因索和多因素Logistic回归分析探索自杀意念的危险因素.结果 有5.56%的医学生报告最近1年内有自杀意念,性别差异无统计学意义;独生子女自杀意念报告率(7.24%)高于非独生子女(4.80%)(P＜0.05).多因素Logistic回归分析表明.自杀意念的主要危险因素有独生子女、抑郁、负性生活事件、消极应对方式、对自杀持肯定态度.结论 心理障碍和负性生活事件等是自杀意念的主要危险因素.应采取必要的预防措施对自杀意念进行早期干预.     

Mental health problems among labour children in the Gaza Strip

Background There is increasing international concern over the rising number of children involved in labour, particularly in developing countries. Despite the multitude of related risk factors, and some evidence on their social needs, there has been limited research on these children's mental health. Methods The aim of this study was to establish the association between labour‐related variables and mental health problems among 780 children in labour (aged 9–18 years, mean 15.8) in the Gaza Strip. Measures included a demographic checklist, the Strengths and Difficulties Questionnaire, the Spence Children's Anxiety Scale and the Depression Self‐rating Scale for Children. Results Children came from large families (73.2% had eight or more siblings), mainly worked to increase family income, worked an average 6.8 h per day (range 1–16), and only 37.1% had regular rest. Ratings of mental health problems were predicted by different factors, i.e. total difficulties scores by poor friendship relationships and lack of health insurance; anxiety scores by selling in the streets, working to help family, low family income and lack of health insurance; and depression scores by parents' dissatisfaction with the job and longer working hours. Conclusions Mental health problems of children in labour are likely to be associated with socio economic determinants, as well as factors related to their under age employment. Policy, legislation and preventive programmes from statutory and voluntary agencies should adopt an integrated approach in meeting their mental health needs, by enhancing protective factors such as return to school.     

Exploring the relationship between transgender-inclusive providers and mental health outcomes among transgender/gender variant people

Using a statewide survey of transgender and gender variant individuals (N = 417), this study examines the association between having a transgender-inclusive provider and three mental health concerns: current experience of depression, lifetime experience of anxiety disorder, and suicidality within the last year. Findings suggest that having a transgender-inclusive provider is associated with decreased rates of depression and suicidality, but not with lifetime experience of having anxiety. Implications for future research and education of providers are discussed.     

社会支持在超重肥胖青少年心理健康与自杀意念间的中介作用

目的 探讨超重肥胖青少年心理健康、社会支持与自杀意念的关系,为促进超重肥胖青少年心理健康发展,降低自杀意念检出率提供指导。方法 2018年3-5月选取潍坊市4 250名青少年,采用自杀意念自评量表(SIOSS)、心理健康自评量表(K10)、社会支持量表(SSRS)进行调查。结果 青少年超重检出率为9.55%(406/4 250),肥胖检出率为6.94%(295/4 250);农村超重肥胖青少年心理健康得分显著高于城市青少年(P<0.001),城市超重肥胖青少年社会支持得分显著高于农村,超重肥胖青少年自杀意念得分农村显著高于城市(P<0.001);心理健康与自杀意念呈显著正相关(r=0.639,P<0.01),社会支持分别与心理健康、自杀意念呈显著负相关(r=-0.378和-0.449,P<0.01);心理健康与社会支持对超重肥胖青少年自杀意念有显著预测作用(β=0.278和-0.197,P<0.01;R²=0.459),且社会支持在心理健康与自杀意念之间起部分中介作用。结论 通过改善超重肥胖青少年的心理健康状况,提高其社会支持,从而降低超重肥胖青少年的自杀意念。