精神生物学因素对预测自杀的再认识

荟萃比较技术 (ＭＣＴ)是一个由阈下感知发展而来的投射测验。以前的荟萃比较技术研究表明 ,其分量表刻板性 (ＳＯ)和自杀存在着显著相关[1] 。ＭＣＴ“刻板性”病人指的是那些不具防御策略的病人 ,他们有很高的自杀风险。Ｆｒｉｂｅｒｇｈ等[2 ] 发现 ,刻板组中绝大多数自杀未遂者最终会成功自杀。从精神病学角度来看 ,刻板性指的是某些动作、情感及思想的长时间重复。尽管抑郁性迟滞的病理生理学原因目前尚未清楚 ,但传统的生物学解释是多巴胺能异常[3] 。其他一些神经递质如γ 氨基丁酸 (ＧＡＢＡ)和肾上腺素据说也与此有关[4 ] 。与自杀…     

危机干预与自杀预防（三）——自杀的生物学标志研究现状（综述）

危机干预与自杀预防（三）自杀的生物学标志研究现状（综述）赵汉清近２０余年来，许多专家对自杀的生物学标志进行了不懈的探索，现就这方面的研究结果作一综述。一、神经介质研究１．５羟色胺（５—ＨＴ）Ａｓｂｅｒｇ等（１９７６）最先发现自杀者脑脊液（ＣＳＦ）中５...     

危机干预与自杀预防(二)--精神疾病患者的危机干预与自杀预防

精神疾病是导致自杀的重要原因之一.加强精神卫生宣传教育,减少酒及其他精神活性物质使用,减少失业的人群总体策略;减少精神疾病患者自杀方法的可获得性及致命性,特别是精神药物处方的选择与限制;精神科医生自杀风险评估训练,识别高危精神疾病患者,予以积极治疗;高风险期间增加服务强度及适当细致的监护.     

精神疾病患者的危机干预与自杀预防

精神疾病是导致自杀的重要原因之一。加强精神卫生宣传教育,减少酒及其他精神活性物质使用,减少失业的人群总体策略;减少精神疾病患者自杀方法的可获得性及致命性,特别是精神药物处方的选择与限制;精神科医生自杀风险评估训练,识别高危精神疾病患者,予以积极治疗;高风险期间增加服务强度及适当细致的监护。     

家庭社会防治与精神病人的社会康复

“家庭社会防治”是社区精神卫生工作的新形式。其含义是指精神病人在家庭环境中接受医疗和护理,以充分利用家庭和社会生活的有利因素,促使病情好转、社会适应和康复。其特点是重视和强调精神病人的早期社会康复。本研究从我国的社会文化背景出发,寻找适合于农村的精神疾病防治途径,探索家庭治疗精神疾病在农村是否可行。     

大学生D型人格与抑郁、绝望及自杀倾向的相关分析

D型人格(Type D personality),是荷兰学者Denollet 于 1996年在对冠心病患者的人格研究中提出的,它包含负性情感(negative,affcctivity,NA)和社交抑制(social inhibition,SI)两个维度,是人群中一种常见的人格特质[1].青少年是生理、心理和人格等方面发展的不稳定时期,此时期开展健康教育,不仅效果较好,也可对自杀预防起到重要作用.目前探讨D型人格与抑郁、绝望、自杀倾向的报道较少,本研究旨在了解大学生中D型人格的分布情况及与抑郁、绝望及自杀倾向的关系,为健康教育提供一定的借鉴.     

烟台农村家庭社会精神病防治与精神病人的康复

烟台市位于山东半岛东部,现辖11个县、市、区,221处乡、镇,7034个自然村,总人口为610万。自1977年以来,在全市普遍开展了农村社区精神卫生服务,以基层卫生保健三级防治网为基础,将精神卫生服务纳入初级卫生保健体系。实行了以家庭病床为主体的对精神病人进行治疗、康复、预防、管理的综合性治理的精神病四级防治网络。十多年来取得了较好的效果和较大的社会效益。     

心理援助热线成年与未成年自杀高危来电者特征及干预效果的影响因素比较

目的 比较心理援助热线成年与未成年自杀高危来电者的特征和影响即刻干预效果的因素,为制定不同年龄人群的热线干预方案提供参考。方法 将北京市心理援助热线于2021年1月-6月接听的2 229例自杀高危来电者纳入研究,分为成年组(n=1 344)和未成年组(n=885)。接线员询问来电者并收集其一般资料、自杀意念、社会心理特征以及主诉问题等资料,比较成年组和未成年组以上资料的差异。在热线干预前后,评估来电者的痛苦程度、自杀意念强烈程度和希望程度,并比较成年组和未成年组的改善情况。采用Logistic回归比较两组来电者三个干预效果指标并探讨其关联因素。结果 与成年组相比,未成年组报告家庭成员关系问题、学习问题、自杀未遂史和害怕被攻击的比例更高,差异均有统计学意义(χ²=55.604、24.706、41.944、106.527,P均<0.01)。电话干预后,未成年组中希望程度改善的比例更高(42.74%vs. 30.97%,χ²=26.042,P<0.01)。多变量Logistic回归分析结果显示,与成年组相比,未成年组中有严重抑郁情绪者痛...     

Prevalence and Risk Factors Associated with Suicide Ideation and Attempts in Korean College Students

Objective

Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students.

Methods

Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki''s suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts.

Results

The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder.

Conclusion

Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.     

Suicide risk in type 1 diabetes mellitus: A systematic review

Background

Research has shown that suicide risk is often present in patients suffering from type 1 diabetes mellitus (DM-1).

Objectives

The aim of the present paper was to investigate whether there was a relationship between DM-1 and suicidal behavior and to determine whether or not people affected by DM-1 are at an increased risk of completed suicide, attempted suicide, and suicidal ideation.

Data sources

We performed a careful MedLine, ExcerptaMedica, PsycLit, PsycInfo and Index Medicus search to identify all papers on the topic for the period 1970 to 2013 written in English. The following search terms were used: (suicide OR suicide attempt OR ideation) AND (diabetes mellitus). Where a title or abstract seems to describe a study eligible for inclusion, the full article was examined.

Eligibility criteria

We included only original articles published in English peer-reviewed journals. We excluded meta-analyses and systematic reviews, studies that were not clear about follow-up times, the method of statistical analysis, diagnostic criteria or the number of patients included, and studies only on patients affected by type 2 diabetes mellitus (DM-2).

Results

The research reviewed indicated that patients with DM-1 are at an increased risk for suicide, although no clear consensus exists regarding the level of the increased risk.

Limitations

The studies used different measurement techniques and different outcomes, and they assessed patients at different time points.

Conclusions and implications

Our findings support the recommendation that a suicide risk assessment of patients with DM-1 should be part of the routine clinical assessment. The assessment of patients at risk should consist of the evaluation of current and previous suicidal behaviors (both suicidal ideation and attempted suicide).     

冲动性和攻击性对大学生自杀未遂行为的影响

目的 了解冲动性及攻击性对大学生自杀未遂行为的影响.方法 采用<自杀态度与心理健康状况问卷(大学版-Ⅳ)>对重庆市随机抽取的11所大学的12000名大学生进行调查.比较有无自杀未遂大学生中文版Barratt冲动行为量表与Buss和Perry攻击问卷的评估结果,分析冲动性及攻击性人格对大学生发生自杀行为的影响.结果 收集有效问卷9808份,大学生自杀未遂的报告率为1.7%(169/9808).自杀未遂组的冲动行为量表中的非计划性、行动冲动性和认知冲动性及总分均高于无自杀未遂组(P<0.001).自杀未遂组Buss和Perry攻击问卷的总分及身体攻击、言语攻击、愤怒、敌意、指向自我的攻击等各因子分均高于无自杀未遂组(P<0.01).多因素条件logistic回归分析显示,与自杀未遂最密切有关的独立危险因素排列为:攻击性总分高(OR=20.81,95%CI:12.36～35.03,P<0.01),行动冲动性分高(OR=4.32,95%CI:2.33～8.01,P<0.01).冲动性总分高(OR=3.37,95%CI:1.65～8.42,P<0.01),非计划性分值高(OR=3.12,95%CI:1.75～5.56,P<0.01),自杀意念强(OR=2.54,95%CI:1.75～3.70,P<0.01),已发生过性行为(3.12,95%CI:1.75～5.56,P<0.01),女性(OR=2.15,95%CI:1.48～3.14,P<0.01),指向自我的攻击分值高(OR=1.89,95%CI:1.24～2.88,P<0.01).结论 有自杀未遂的大学生更多体现出冲动性及攻击性人格,对大学生冲动性自杀行为应采取不一样的干预方案.     

Contents of the Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea,Version 2.0

ObjectiveSuicide is a huge nationwide problem that incurs a lot of socio-economic costs. Suicide also inflicts severe distress on the people left behind. The government of the Republic of Korea has been making many policy efforts to reduce suicide rate. The gatekeeper program, ‘Suicide CARE’, is one of the meaningful modalities for preventing suicide. MethodsMultidisciplinary research team collaborated to update the ‘Suicide CARE’ to version 2.0. ResultsIn the ‘Introductory part’, the authors have the time to think about the necessity and significance of the program before conducting full-scale gatekeeper training. In the ‘Careful observation’ part, trainees learn how to understand and recognize the various linguistic, behavioral, and situational signals that a person shows before committing suicide. In the ‘Active listening’ part, trainees learn how to ask suicide with a value-neutral attitude as well listening empathetically. In the ‘Risk evaluation and Expert referral’ part, trainees learn intervening strategies to identify a person’s suicidal intention, plan, and past suicide attempts, and connect the person to appropriate institutes or services. ConclusionSubsequent studies should be conducted to verify the efficacy of the gatekeeper program.     

Suicide in the island of Singapore

In a study of suicide in Singapore in 1980 there were 230 cases and the suicide rate for the general population was 9.5 per 100,000. The age-specific rates increased steeply after 50 years and there was a male preponderance especially in the age group 60 years and over. Comparing the three major ethnic groups in Singapore, the highest rate was seen in the Indians and Chinese, whereas the Malays had the lowest. Amongst the suicides there were 59 (25.7%) with mental illness, mainly schizophrenia, and they were of a younger age group, 20-39 years. The commonest method of suicide was jumping from high-rise flats.     

Mental Health and Social Isolation Among Survivors Ten Years After a Suicide in the Family: A Case-Control Study

The aim of this study was to investigate mental health and social isolation in surviving family members (n=56) 10 years after a suicide as compared to sex and age matched general population controls. Minor mental disorders were more common among suicide survivors than among general population controls (30% vs. 16%), especially in surviving spouses (39% vs. 11%). Suicide survivors had fewer close friends than their controls. According to multivariate logistic regression analyses adjusted for several socioeconomic factors and the number of close friends, surviving spouses, but not relatives by blood, had a significantly increased risk of having minor mental disorder as compared to general population controls. Our conclusion is that suicide may be associated with mental symptoms and lack of social relationships in surviving spouses even 10 years later.     

Suicide in Lithuania

The data on the rate of the suicide in the periods of 1924–1939 and 1962–1993 are presented from the Statistics Annals and the Archives of the Statistics Department of Lithuania. In pre-war independent Lithuania (1924-1939) the suicide rate was 5-10 suicides per 100,000 citizens. During the Soviet occupation period it was constantly increasing until it reached 35.8 per 100,000 in the year of 1984. The changes towards a more democratic society resulted in a diminished suicide rate (to 25.1 per 100,000 in 1986); the same processes were taking place in other countries of the former Eastern block. In the period of the present economic hardships the rate of suicide in Lithuania has increased up to 42.0 per 100,000 (in 1993). Obvious increase in the rate of suicides among men and people of advanced age is observed. The article draws a comparison between the suicide notes of Lithuania and other European countries. The dependence of the suicide rate on socio-political changes, secularisation and anomie is also discussed in this article.     

Suicide in the elderly in Austria

In most countries men and women have the highest suicide rates in age groups over 60 years. We investigated suicide rates for the elderly in Austria, a country with one of the highest suicide rates in the world, for the period 1980–1991, using data from the Federal Statistical Division. Suicide rates remained stable over the last decade at a very high level. The mean rate for men was 85.2, for women 28.6/100 000. In men and women rates rise with age. The mean rate of men rises from 51.2 (60–64 years) to 117.3/100 000 (over 85 years); in women there is an increase from 21.4 (60–64 years) to 32.8/100 000 (over 85 years). We did not confirm findings in other countries, where suicide rates have increased in recent years.