青少年自杀20例分析

近年来,自杀现象增多,尤其是青少年自杀现象增多,已构成一个令人关注的社会问题。为了解青少年自杀的原因,预防青少年自杀的发生,对20例青少年自杀进行了分析。 资料和方法 一 对象 为我院1996年10月～1999年6月门诊抢救的病人和所在地区中学中发生的青少年自杀死亡者共20例,排除自杀前有精神疾患和重大躯体疾患,年龄在9～18岁之间。 二 方法 通过询问其父母及学校老师,用自编问卷对患者性别、年龄、性格、是否独子、自杀     

香港青少年自杀及其防止

香港自杀者的年龄有下降趋势，青少年自杀事件已引起社会公众的关注。本文对这一问题进行探讨，提出预防自杀的意见和建议。     

青少年自杀相关因素研究现状及进展分析

自杀是全球青少年主要死亡因素之一。近年来我国青少年自杀人数呈不断上升趋势。探讨青少年自杀的相关保护因素和危险因素,对于有效地、针对性地改善青少年的心理健康问题、预防青少年自杀具有重要意义。自杀因素主要由外在因素与内在因素两方面组成,外在因素即为外界环境中能对个体自杀观念和行为产生明显影响的因素,内在因素即为个体自身存在的能导致个体更易产生自杀观念和自杀行为的因素。本综述从两方面多分析青少年自杀因素的流行趋势、因素分类与特点,并由此为青少年自杀的防治提出建议。     

我国青少年自杀研究及预防对策

近年来,青少年自杀渐增,本文分析青少年自杀原因,并提出自杀预防对策,包括早期发现自杀倾向,广泛开展青少年心理健康教育及建立自杀预防热线。     

青少年抑郁障碍患者与双相情感障碍患者睡眠特征及其对自杀风险的影响

目的 比较青少年抑郁障碍患者和双相情感障碍患者睡眠结构特征的差异,探讨睡眠指标等因素对患者自杀风险的影响。方法 回顾性查阅广州医科大学附属脑科医院2019年1月1日-2021年6月30日符合《国际疾病分类（第10版）》（ICD-10）诊断标准的抑郁障碍（n=97）和双相情感障碍（n=52）住院青少年患者病历资料,收集患者的年龄、性别、体质量指数（BMI）、精神科诊断、自杀风险评估量表（NGASR）评分及多导睡眠监测（PSG）结果。根据NGASR评分结果,将患者分为两组：0~5分为自杀低风险组（n=32）,>5分为自杀高风险组（n=117）。以既往文献中80例正常青少年的PSG数据作为对照组资料。建立多元线性回归模型探讨青少年情感障碍患者自杀风险的影响因素。结果 自杀高风险组睡眠效率和N2期睡眠占比均低于自杀低风险组（Z=-2.138、-2.520,P均<0.05）。抑郁组总睡眠时间、N2期睡眠时间以及REM期睡眠时间均少于双相组（t=-2.822、-3.087、-2.277,P<0.05或0.01）;抑郁组和双相组REM期睡眠占比均低于对照组（t=-2.369、-2.069,P均<0.05）。线性回归分析显示,青少年情感障碍患者自杀风险的影响因素包括N1期睡眠时间（β=0.019,P<0.05）、性别（男性vs.女性,β=-4.051,P<0.01）以及诊断（双相情感障碍vs.抑郁障碍,β=-1.429,P<0.05）。结论 与青少年双相情感障碍患者相比,青少年抑郁障碍患者存在睡眠连续性差、浅睡眠更少的特点。N1期睡眠时间、女性以及诊断为抑郁障碍是青少年情感障碍患者自杀的影响因素。     

老年女性抑郁症患者客观睡眠特征和自杀意念的相关性研究

目的 探讨老年女性抑郁症患者客观睡眠特征和自杀意念的相关性。方法 采用方便抽样法，选取2019年4月至2021年12月在安徽省精神卫生中心住院的128例老年女性抑郁症患者为研究对象。根据汉密尔顿抑郁量表（HAMD）第3个条目得分将患者分为有自杀意念组（n=81）和非自杀意念组（n=47）。采用多导睡眠监测评估患者的总睡眠时间、睡眠潜伏期、睡眠效率、快速眼动睡眠潜伏期（REML）、觉醒次数、觉醒总时间、非快速眼动睡眠在各阶段睡眠（N1、N2、N3期）时间、快速眼动睡眠期。比较两组患者的一般资料、抑郁症状严重程度和客观睡眠特征。采用二项Logistic回归分析老年女性抑郁症患者客观睡眠特征与自杀意念的关系。结果 单因素分析结果显示，两组患者的职业类别、HAMD得分、睡眠效率、总睡眠时间、觉醒总时间、觉醒次数、N1期睡眠时间、N2期睡眠时间、N3期睡眠时间、REML比较，差异有统计学意义（P<0.05）。二项Logistic回归分析显示，在控制了职业类别和抑郁症状严重程度后，睡眠效率（OR=0.857,95%CI=0.748～0.983）、总睡眠时间（OR=0.971,95%CI=0....     

青少年自杀的家庭危险因素探析

家庭因素是引发青少年自杀的重要因素之一。青少年自杀的家庭危险因素包括生物遗传因素及家庭精神健康、家庭关系、家庭结构、家庭功能等家庭环境因素。     

青少年失眠状况和睡眠质量及二者相关性分析

目的调查青少年失眠状况和睡眠质量及二者之间的相关性。方法对技工学校学生统一发放4733份调查问卷,最终获得有效问卷3342份,记录社会人口学资料,包括性别、年龄、身高、体重、健康状况、户籍、是否为独生子女、父母受教育程度、家庭收入、学习压力、吸烟和饮酒等,以及睡眠和情绪相关量表评分,包括失眠严重指数(ISI)中文版、匹兹堡睡眠质量指数(PSQI)、Epworth嗜睡量表(ESS)、焦虑自评量表(SAS)和Beck抑郁量表(BDI)。结果 3342名青少年中存在失眠997例(29.83%)、日间嗜睡568例(17.00%)、焦虑243例(7.27%)和抑郁1287例(38.51%)。根据ISI中文版评分分为非失眠组(2345名)和失眠组(997例),失眠组女性(P=0.000)、健康状况不良(P=0.000)、非独生子女(P=0.006)、有学习压力(P=0.000)和吸烟(P=0.027)比例,以及ISI中文版评分(P=0.000)、ESS评分(P=0.000)、SAS评分(P=0.000)和BDI评分(P=0.000)均高于非失眠组。Pearson相关分析显示,ISI中文版评分和PSQI评分均与ESS评分(r=0.361,P=0.000;r=0.064,P=0.000)、SAS评分(r=0.326,P=0.000;r=0.069,P=0.000)和BDI评分(r=0.529,P=0.000;r=0.067,P=0.000)呈正相关,且ISI中文版评分的上述相关性(r=0.300～0.600)高于PSQI评分(r0.100)。进一步偏相关分析显示,ISI中文版评分与PSQI评分呈负相关(r=-0.056,P=0.001)。结论失眠组女性更多、健康状况更差、非独生子女更多、学习压力更大、吸烟比例更高,以及日间嗜睡、焦虑和抑郁更严重。与PSQI量表相比,ISI量表中文版与日间嗜睡、焦虑和抑郁的关系更紧密,可能更适用于筛查和评价青少年失眠状况。     

儿童青少年抑郁症自杀及相关影响因素研究

目的 探讨儿童青少年抑郁症患者中自杀相关影响因素.方法 选取2018年1月至2019年12月就诊于河北省第六人民医院的389例儿童青少年抑郁症患者作为研究对象,其中自杀组171例,非自杀组218例.对两组间的一般情况与临床特征进行比较,并采用Logistic回归方法对青少年儿童抑郁症伴自杀的影响因素进行分析.结果 自杀...     

儿童青少年与老年抑郁症患者自杀危险因素比较

目的 比较精神科儿童青少年和老年抑郁症患者的自杀危险因素,认识两类人群自杀危险的特点,有针对性地预防自杀.方法 采用自制的自杀危险评估表对210例儿童青少年和老年抑郁症患者进行评估.结果 在健康状况、焦虑程度、药物副反应、自杀史、人际关系、性格特征方面儿童青少年和老年患者存在明显差异.结论 儿童青少年和老年抑郁症患者自杀意念具有不同的特点,需根据不同特点针对性地采取不同的预防措施.     

Self-compassion and family cohesion moderate the association between suicide ideation and suicide attempts in Chinese adolescents

BackgroundIn recent years, many studies have examined risks factors that facilitated the transition from suicide ideation to suicide attempts. Few studies, however, have examined protective factors against this transition. The current study thus assessed two protective factors, self-compassion and family cohesion, in buffering the transition from suicide ideation to suicide attempts.MethodA number of 520 Chinese adolescents (43.46% females, mean age = 12.96 years) completed questionnaires assessing self-compassion, family cohesion, suicide ideation, and suicide attempts two times with a 12-month interval.ResultsSelf-compassion significantly moderated the association between Wave 1 SI and later SA. The positive dimension of self-compassion thwarted the transition from SI and SA, and the negative dimension of self-compassion strengthened the associations. In addition, family cohesion also significantly moderated the transition from SI to SA.ConclusionIncreasing the levels of self-compassion and family cohesion may be the targets for treating adolescents with suicide ideation to prevent them from attempting suicide.     

Alcohol consumption and sleep problems in Hong Kong adolescents

ObjectiveWe aimed to investigate the relationship between alcohol consumption and sleep problems among Hong Kong adolescents.MethodsIn the 2006 and 2007 Hong Kong Student Obesity Surveillance project, 33,692 secondary students completed an anonymous questionnaire on lifestyles and health. Alcohol consumption was categorized as nondrinkers (reference group), those who drank less than 1 day per week (less than weekly drinkers), and those who drank 1 to 7 days per week (weekly drinkers, including some daily drinkers). Students reported if they had any sleep problems in the past 30 days, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), snoring, and difficulty breathing during sleep (DBS). Insomnia was defined as any reports of DIS, DMS, or EMA. Logistic regression was used to assess the association between alcohol and each sleep problem. Multiple imputations were used to impute missing data.ResultsCompared with nondrinkers, less than weekly and weekly drinkers were more likely to report snoring with adjusted odds ratios (AOR) of 1.64 (95% confidence interval [CI], 1.40–1.92) and 1.82 (95% CI, 1.55–2.14), respectively (P < .001). The corresponding figures were 1.24 (95% CI, 1.02–1.50) and 1.50 (95% CI, 1.24–1.82) for DBS (P < .001) and 1.12 (95% CI, 1.02–1.22) and 1.15 (95% CI, 1.04–1.27) for insomnia (P = .002). Weekly drinking was positively associated with DMS but negatively associated with DIS and EMA. Less than weekly drinking was positively associated with DIS, DMS, and EMA.ConclusionsBoth less than weekly drinking and weekly drinking were associated with snoring, DBS, and insomnia. The association of individual symptoms of insomnia with drinking varied with the frequency of consumption.     

The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report

BackgroundPrevious studies have suggested a bidirectional association between sleep problems and anxiety symptoms in adolescents. These studies used methods that do not separate between-person effects from within-person effects, and therefore their conclusions may not pertain to within-person mutual influences of sleep and anxiety. We examined bidirectional associations between sleep problems and anxiety during adolescence and young adulthood while differentiating between person effects from within-person effects.MethodsData came from the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study including six waves of data spanning 15 years. Young adolescents (N = 2230, mean age at baseline 11.1 years) were followed every 2–3 years until young adulthood (mean age 25.6 years). Sleep problems and anxiety symptoms were measured by the Youth Self-Report, Adult Self-Report and Nottingham Health Profile. Temporal associations between sleep and anxiety were investigated using the random intercept cross-lagged panel model.ResultsAcross individuals, sleep problems were significantly associated with (β = 0.60, p < 0.001). At the within-person level, there were significant cross–sectional associations between sleep problems and anxiety symptoms at all waves (β = 0.12–0.34, p < 0.001). In addition, poor sleep predicted greater anxiety symptoms between the first and second, and between the third and fourth assessment wave. The reverse association was not statistically significant.ConclusionsWithin-person associations between sleep problems and anxiety are considerably weaker than between-person associations. Yet, our findings tentatively suggest that poor sleep, especially during early and mid-adolescence, may precede anxiety symptoms, and that anxiety might be prevented by alleviating sleep problems in young adolescents.     

Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder

Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6–15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH-U-KSADS and the CDRS-R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed.     

Association between sleep duration and menstrual cycle irregularity in Korean female adolescents

ObjectiveThe association between sleep and the menstrual cycle in the adolescent population has been scarcely studied. This study aimed to investigate the association between sleep duration and menstrual cycle irregularity among female adolescents using nationwide representative data from the South Korean population.MethodsThis population-based, cross-sectional study used the data collected from Korea National Health and Nutrition Examination Survey 2010–2012, and the data from 801 female adolescents were analyzed. Hierarchical multivariable logistic regression analysis was performed to assess the risk of menstrual cycle irregularity in relation to sleep duration.ResultsSubjects with menstrual cycle irregularity accounted for 15% (N = 120). The mean sleep duration in subjects with menstrual cycle irregularity was significantly shorter than that in those without (p = 0.003). Menstrual cycle irregularity prevalence tended to decrease as sleep duration increased (p for trend = 0.004), which was significantly different based on sleep duration and presence of depressive mood (p = 0.011). Sleep duration ≤5 h per day was significantly associated with increased risk of menstrual cycle irregularity compared with that in the subjects whose sleep duration is ≥8 h per day even after adjusting for confounding variables. The odds ratios of menstrual cycle irregularity tended to increase for shorter sleep duration in all adjusted models.ConclusionThis study found a significant inverse association between sleep duration and menstrual cycle irregularity among Korean female adolescents. Increasing sleep duration is required to improve the reproductive health of female adolescents.     

Parent reports of sleep/alertness problems and ADHD symptoms in a sample of obese adolescents

OBJECTIVE: Recent evidence suggests an association between obesity and Attention Deficit/Hyperactivity Disorder (ADHD) or ADHD traits. The characteristics of obese subjects with a higher probability of ADHD symptoms are still unclear. We explore the hypothesis that obese adolescents with sleep/alertness problems represent a subgroup at high risk for ADHD traits, independently from associated symptoms of anxiety/depression. The aim of this study was to assess the relationship between parent reports of sleep/alertness problems and ADHD traits in a clinical sample of obese adolescents, controlling for symptoms of anxiety/depression. METHODS: Seventy obese subjects (age range, 10-16 years) were included. The parents filled out the Sleep Disturbance Scale for Children (SDSC), the Conners Parents Rating Scale-Revised (Short Version) (CPRS-R:S), and the Child Behavior Checklist (CBCL). The ADHD Rating Scale (ADHD-RS) was completed by a child psychiatrist. RESULTS: Using multiple regression models controlling for symptoms of anxiety/depression, scores of excessive daytime sleepiness on the SDSC were significantly associated with ADHD traits on the CPRS-R:S as well as on the ADHD-RS. CONCLUSIONS: Obese adolescents described as excessively sleepy by their parents may be at higher risk of ADHD symptoms, independently from symptoms of anxiety/depression. Although the clinician may overlook a potential diagnosis of ADHD in obese adolescents described as sleepy, the results of this study suggest to systematically look for symptoms of ADHD in this subgroup of obese patients. Further studies using objective methods to assess sleep/alertness disturbances are needed to gain insight into the relationship between sleep/alertness disturbances and ADHD in obese individuals.     

Prevalence and determinants of suicide ideation among Lebanese adolescents: Results of the GSHS Lebanon 2005

The current study examined prevalence and risk factors for suicide ideation in 5038 Lebanese adolescents using Global School Health Survey data. Around 16% of Lebanese adolescents thought of suicide. Multivariate logistic regression models showed that risk factors for suicide ideation included poor mental health (felt lonely, felt worried, felt sad or hopeless), substance use (got drunk, used drugs), victimization (was bullied, was sexually harassed), and lack of parental understanding. Recommendations for future research and interventions are discussed.     

Comorbidity patterns in adolescents and young adults with suicide attempts

The role of comorbidity as a risk for suicide attempts is investigated in a random sample of 3021 young adults aged 14–24 years. The M-CIDI, a fully standardized and modified version of the Composite International Diagnostic Interview, was used for the assessment of various DSM-IV lifetime and 12-month diagnoses as well as suicidal ideation and suicide attempts. Of all suicide attempters, 91% had at least one mental disorder, 79% were comorbid or multimorbid respectively and 45% had four or more diagnoses (only 5% in the total sample reached such high levels of comorbidity). Suicide attempters with more than three diagnoses were 18 times more likely (OR = 18.4) to attempt suicide than subjects with no diagnosis. Regarding specific diagnoses, multivariate comorbidity analyses indicated the highest risk for suicide attempt in those suffering from anxiety disorder (OR = 4.3), particularly posttraumatic stress disorder followed by substance disorder (OR = 2.2) and depressive disorder (OR = 2.1). Comorbidity, especially when anxiety disorders are involved, increases the risk for suicide attempts considerably more than any other individual DSM-IV diagnoses. Received: 17 July 1997 / Accepted: 15 December 1997     

Affective problems,gastrointestinal symptoms,sleep problems,and challenging behaviour in children and adolescents with autism spectrum disorder

BackgroundPeople with autism spectrum disorder (ASD) can experience affective problems, gastrointestinal (GI) symptoms, sleep problems, and challenging behaviour. This study identified the frequency of affective problems and explored how they related to co-occurring conditions in children and adolescents with ASD.MethodParticipants were children and adolescents diagnosed with ASD using DSM-IV-TR criteria (n = 95), 40 % (n = 38) of whom also had a diagnosis of intellectual disability (ID). The following scales were completed by the participants’ parents or guardians: Child Behaviour Checklist (CBCL), Gastrointestinal Symptoms Inventory, Children’s Sleep Habits Questionnaire (CSHQ), and the Behaviour Problems Inventory-Short Form (BPI-S). Pearson’s correlations and independent sample t-tests were used to examine the relationships between variables. Two hierarchal multiple regressions examined predictors for affective problems in preschool and school-aged children with ASD.ResultsParticipants scored in the clinical range (69.5 %) and borderline range (10.5 %) for affective problems. Significant positive relationships were found between affective problems and sleep problems, GI symptoms, and challenging behaviour. ID and gender predicted affective problems in preschool aged children. In school-aged children, affective problems were predicted by ID, sleep problems, and aggressive/destructive behaviour severity. However, only 25 % of the variance in affective problems was accounted for.ConclusionsFuture research is needed to understand how affective problems are impacted by co-occurring conditions in children and adolescents with ASD. Affective problems are prevalent in this population and the quality of life for individuals may be improved if practitioners consider co-occurring conditions during clinical practice.     

The relationship between subjective happiness and sleep problems in Japanese adolescents

ObjectivesLow sleep quality in adolescents is an important public health concern, as it relates to both their current and future physical and mental health. Furthermore, subjective happiness is also often regarded as a major life goal. Although Japan is an economically powerful country, the reported levels of subjective happiness among Japanese adolescents is low. Thus, this study aims to examine the relationship between subjective happiness and sleep problems in Japanese adolescents.MethodsWe conducted a nationally representative cross-sectional study of adolescents enrolled in junior and senior high schools in Japan. We used a questionnaire to determine the prevalence of sleep problems (eg, insomnia, short sleep duration (SSD) and poor sleep quality) and to evaluate the participants' reported levels of subjective happiness. Multivariable logistic regression analyses were used to examine the associations between subjective happiness and sleep problems. Adjusted variables were basic demographic characteristics (eg, gender and school grade), lifestyle behaviors, and mental health status.ResultsData from 64,329 students were analyzed (age range 12–18 years, mean age 15.7 years, 53.9% male). The results indicated that reported levels of subjective happiness were strongly associated with the prevalence of sleep problems. Linear relationships can be observed between sleep problems and subjective happiness scores. The multivariable logistic regression analysis showed that dose–response association of subjective happiness score was observed with all three sleep problems.ConclusionsDue to these findings, we recommend that policy makers and school officials educate adolescents on the importance of both subjective happiness and good sleep hygiene.