天水市农村女性自杀未遂者危险因素研究

目的:探讨甘肃天水市农村自杀未遂女性的自杀危险因素。方法:对天水市3个县区23个乡镇自杀未遂报告系统2007年6月至2009年1月报告的年龄≥14岁的自杀未遂女性150人(自杀未遂组)及由同一报告者提供的近1年内无自杀行为、年龄、居住地相匹配的正常女性150人(正常对照组)分别采用自编《伤害幸存者研究问卷》和《正常对照者研究问卷》进行自由访谈及问卷调查;分析自杀行为的危险因素。结果:自杀未遂组在文盲、人均年收入低、现患精神障碍、有人格障碍、对自杀接受性高、自杀意念强、既往有自杀未遂史、近1个月有过失眠、近1个月因心理问题难以工作、近1年有生活事件、急/慢性应激高、生命质量低、冲动性及攻击性高、家庭亲密性及家庭适应性低、社会支持差的发生率上明显高于正常对照组(χ~2=5.051~71.082,P0.05或P0.001);自杀行为特征为冲动性、服农药、家庭纠纷或为解脱痛苦。Logistic回归分析显示年龄40岁、文盲、现患精神障碍、对自杀接受性高、近1月因心理问题难以工作、近1年有生活事件、急性应激高、攻击性高、家庭亲密性低进入方程。结论:服药是天水市农村女性最常见的自杀方式;年龄40岁、文盲、现患精神障碍、对自杀接受性高、近1月因心理问题难以工作、近1年有生活事件、急性应激高、攻击性高、家庭亲密性低是天水农村女性自杀行为的危险因素。     

昏迷危险因素的病例对照研究

目的研究昏迷发病的危险因素。方法连续收集223例住院的昏迷病人作为病人组(昏迷组).以同期住院的223例危重非昏迷病人为对照组(非昏迷组)。采用统一调查表和诊断标准对所有对象的一般情况、原发或主要疾病、急性并发症或器官衰竭、慢性脏器功能障碍等进行调查。应用单因素和多因素分析方法对有关因素进行分析。结果单因素分析表明,符合3项和4项标准的全身炎症反应综合征(SIRS 3-4)、急性呼吸衰竭、休克、急性肾衰、血糖过高、继发性全身性癫痫、第二原发疾病、原有脑软化,是昏迷的危险因素(P<0.05)。Logistic回归在校正了休克等因素后,SIRS3-4(OR=7.8,95％CI=4.307-14.001)、急性呼吸衰竭(OR=5.2,95％CI=1.683-16.242),继发性全身性癫痫(OR=2.6,95％CI=1.095-5.998)仍与昏迷密切有关。结论除昏迷的原发疾病外,多种急性并发症或器官衰竭,包括SIRS 3-4、急性呼吸衰竭、继发性全身性癫痫等,也是昏迷的主要危险因素。这些危险因素可以联合或单独作用引起昏迷。     

抑郁症自杀未遂的危险因素研究

为探讨抑郁症自杀未遂的危险因素，对５１例有自杀未遂和１５２例无自杀行为的抑郁症患者进行了自杀未遂的危险因素研究。结果表明，Ｌｏｇｉｓｔｉｃ回归筛选出的主要危险因素为自杀家族史、病前生活事件、妄想、自责自罪和绝望；单因素分析筛选出的主要危险因素为性别、自杀家族史、病前生活事件、起病形式、幻觉，妄想、焦虑激越、自责自罪和绝想。     

精神分裂症自杀行为危险因素的病例对照研究

为探讨精神分裂症患者自杀行为的危险因素，对７９例有自杀行为的精神分裂症患者和４９３例无自杀行为的精神分裂症患者进行了病例对照研究。结果显示，ｌｏｇｉｓｔｉｃ回归分析筛选出的主要危险因素为：自然家庭史、病前生活事件，精神分裂症偏执型，亡想，抑郁；单因素分析筛选出的主要危险因素为：自杀家庭史，病前生活事件，慢性精神分裂症，精神分裂症偏执型，亡想，抑郁和反复住院。提示精神分裂症自杀行为与生物－心理－社会     

维吾尔族脑血管病危险因素的病例对照研究

目的 :探讨维吾尔族脑血管病的危险因素。方法 :对 88例病人进行 1∶1配比的病例对照研究。结果 :单因素分析筛选出 7个危险因素 ,又经多因素Logistic回归分析出家族史、夜间工作、高血压、喜咸食是主要的危险因素。结论 :提示家族史、经常夜间工作、高血压、喜咸食可能是维吾尔族脑血管病的主要危险因素     

中国六城市多种危险因素对脑血管病影响的分析(病例—对照研究)

本文对我国六城市神经系病流调发现的脑血管病(CVD)435例进行了病例及对照多种危险因素影响分析。系在单因素分析基础上用 Logistic 逐步回归方法。结果说明高血压史为各类 CVD 的最危险因素,CVD 家族史、糖尿病史、过食咸食、心脏病史分别为所有 CVD、脑梗塞、出血性 CVD、TIA 的主要危险因素。     

卒中后癫痫危险因素的病例对照研究

目的通过了解卒中后癫痫的临床特征,探讨影响卒中后癫痫发生的危险因素。方法本研究采用病例对照研究设计,选择确诊的脑卒中后发生癫痫的患者80例为病例组;脑卒中未发生癫痫患者80例为对照组。收集两组年龄、性别、高血压史、糖尿病史、脑卒中类型、脑卒中部位、心电图检查结果和血清学检查结果等资料,分析卒中后癫痫的危险因素。资料录入采用Epidata3.2,统计分析采用SPSS 13.0。计量资料采用t检验,计数资料采用χ2检验,检验标准α=0.05。采用Logistic回归模型对卒中后癫痫的危险因素进行单因素和多因素回归分析。结果单因素Logistic回归分析结果显示:房颤、卒中部位累及皮质、颞叶、血清钠值、氯值与卒中后癫痫的发生有关(P<0.05);多因素Logistic回归分析结果表明,卒中部位累及皮质(OR=3.53,P=0.002,95%CI=1.62~7.69)、卒中位于颞叶(OR=3.06,P=0.015,95%CI=1.28~7.35)和血清氯值(OR=1.21,P=0.012,95%CI=1.04~1.40)是卒中后癫痫的危险因素。结论卒中部位累及皮质、位于颞叶和血清氯是卒中后癫痫的危险因素,应采取针对性的措施进行干预。     

无症状性脑梗塞危险因素的病例对照研究

采用病例对照与多因素分析相结合的方法，调查了３１９例无症状性脑梗塞患者和３１９例对照者，研究无症状性脑梗塞发生的危险因素。条件Ｌｏｇｉｓｔｉｃ回归分析提示，职业、舒张压的增高、体重指数（ｋｇ／ｍ２）、饮食习惯、饮酒指数对该疾病发生的作用无相关性（Ｐ＞０．０５），无症状性脑梗塞发生的主要危险因素依次为单纯收缩期高血压，血粘度增高、冠心病、吸烟指数、脾气暴躁及易激动、糖尿病。结果表明，无症状性脑梗塞的发生是多种因素单独作用和交互作用的结果。单纯收缩期高血压是首位危险因素。     

精神分裂症患者复发危险因素的病例对照研究

为了探讨精神分裂症复发的危险因素,对81例精神分裂症患者的复发情况进行了调查。结果显示:1年内复发率为51.85％,多因素分析筛选出的主要危险因素为社会功能明显差,治疗依从性差,明显的精神刺激和有精神病家族史;单因素分析筛选出的危险因素还有不能定期复诊,药物维持治疗中断,对疾病缺乏认识和病前人格明显缺陷。本文对复发的危险因素和预防复发的措施,进行了讨论。     

A study of attempted suicides in urban versus rural areas, with a follow-up.

The group of subjects consisted of 44 patients (attempters) who were admitted to hospital for treatment because of attempted suicide during a 3-month period in Norther Savo (in Eastern Finland), another 44 patients (non-attempters) admitted to hospital in the same period for other reasons serving as controls. The number of women was the same in both groups, and so was, in consequence, the number of men. The study compared the attempters with the non-attempters and, in addition, the patients coming from urban areas with those coming from rural areas, the ratio of the urban to the rural patients being the same in both groups. The study was based on personal psychiatric interviews with the patients, which took place in each case both immediately following the patient's admission and precisely 3 months afterwards. The results showed that schizophrenia was significantly more frequent in the rural than in the urban attempter group. By contrast, alcoholism and alcohol abuse were more frequent in the urban than in the rural attempter group. Compared with the urban patients, the rural patients tended to be physically more seriously desordered. Poisoning by drugs was a significantly more frequent means of attempted suicide in the urban than in th rural group. The patients in the latter group, again, had resorted oftener to the so-called "active" methods of attempted suicide. Of the attempters, 25% attempted suicide anew during the 3-month follow-up period, the corresponding figure for the non-attempter group being only 6%. During the follow-up period, a greater number of suicidal attempts was made by the patients in the rural group than by those in the urban group, and, as regards the intent to succeed, the attempts of the former were more serious than those of the latter. The so-called "active" methods were used more often by rural than by urban patients also during the follow-up period. All in all, the self-destructive behaviour exhibited during the follow-up period was graver in the rural than in the urban group.     

农村地区有、无精神障碍自杀未遂者及其自杀特征的比较

目的　比较农村地区有、无精神障碍自杀未遂者的特征。方法　以 1998年 8月至 2 0 0 0年 8月四所县 (市 )级综合医院急诊室中自杀未遂者 (共 5 78例 )为研究对象 ,有 32 6例完成自制问卷调查 ;其中 12 9例 ( 39 6 % )符合美国精神障碍诊断与统计手册第 4版中精神障碍的诊断标准 (有精神障碍组 ) ,197例 ( 6 0 4 % )无精神障碍 ,比较两组的特征。结果　 ( 1)两组社会人口学各变量的差异均无显著性 (P >0 0 5 ) ;有精神障碍组既往有自杀未遂史的比例 ( 2 7 9% )高于无精神障碍组 ( 8 2 % ) ,而口服农药 ( 75 2 % )和冲动性自杀的比例 ( 2 7 3% )低于无精神障碍组 (分别为 88 3%和 6 9 4 % ) ;( 2 )有精神障碍组的自杀意图强、慢性负性生活事件 (对心理影响≥ 1年 )多 ,急性应激强度小 (均P <0 0 0 1)。结论　有、无精神障碍自杀未遂者及自杀特征明显不同 ,对两种自杀人群应采取不同的干预措施。     

Social dysfunction in depressives and attempted suicides

In this study, a group of depressed patients who did not attempt suicide was compared with a group of depressed patients who attemptd suicide. All were English females. The two groups were comparable with regards to social class, and marital status. The suicidal group was younger. The results show no significant difference between the two groups in the degree of severity of depression, which was assessed using the Hamilton Depression Rating Scale. However, there was a significant difference in the degree of social dysfunction between the two groups. This was assessed using the Social Dysfunction Rating Scale described by Linn and co-authors.     

Nicotine use in suicides: a case-control study.

PURPOSE: Despite of higher rates of substance-related disorders in psychiatric patients and suicides than in the general population, there is no clear specificity to the relationship between nicotine use and other psychiatric disorders for suicide risk. METHODS: One hundred and sixty-three suicides (mean age 49.8 +/- 19.3 years; 64.4% males; using psychological autopsy method) and 396 control persons (mean age 51.6 +/- 17.0 years; 55.8% males) were assessed with a standardised semi-structured interview including SCID-I and SCID-II (for DSM-IV). Suicides and controls were compared in terms of nicotine consumption and psychiatric disorders. Logistic regression was used to evaluate the interactions of tobacco consumption with psychiatric disorders. RESULTS: Suicides were significantly more often current smokers and heavy users of cigarettes (> 20 cigarettes per day; P < 0.001, each). Alcohol dependence, other axis I disorders than substance-related disorders, and cluster B personality disorder(s) remained independent predictors for suicide in both genders, current nicotine consumption only in men (OR = 2.6, 95% CI 1.3-5.2). DISCUSSION AND CONCLUSIONS: In males, but not in females, nicotine consumption contributed to risk of completed suicide after control for psychiatric disorders and has to be considered as independent risk factor for suicide.     

Mental disorder in elderly suicides: a case-control study

OBJECTIVE: The authors' goal was to study the importance of different psychiatric disorders in relation to suicide in individuals 65 years old or older. METHOD: The psychological autopsy approach was used to study 85 cases of suicide among subjects who were 65 years old or older; 153 living comparison subjects from the same age group who were randomly selected from the tax register were interviewed face-to-face. Retrospective axis I diagnoses were made according to DSM-IV on the basis of interview data and medical records. RESULTS: Ninety-seven percent of the suicide victims fulfilled criteria for at least one DSM-IV axis I diagnosis, compared with 18% of the living comparison subjects. Recurrent major depressive disorder was a very strong risk factor for suicide, as was substance use disorder. An elevated risk was also associated with minor depressive disorder, dysthymic disorder, psychotic disorder, single-episode major depressive disorder, and anxiety disorder. Comorbid axis I disorders were observed in 15 (38%) of the 39 elderly subjects with major depressive disorder who had committed suicide. CONCLUSIONS: Although recurrent major depressive disorder was the mental disorder most strongly associated with suicide, the findings of this study suggest that elderly individuals who commit suicide represent a heterogeneous group with regard to mental disorders, implying a need for differentiated prevention strategies.     

Pesticides availability and medically serious suicide attempts in China

The case-control study of attempted suicide by Jiang and colleagues[1] that appeared in the last issue of the Shanghai Archives of Psychiatry,reminds us of the many peculiarities and differences in suicidal behavior around the world.The study examined characteristics of medically serious suicide attempters (defined as individuals with a hospital admission longer than 6 hours) in a rural part of Shandong Province,China.     

Suicide in schizophrenia: a retrospective case-control study of 51 suicides

The aim of this study was to identify factors associated with suicide in patients with schizophrenia who required inpatient admission and to compare these factors with the risk profile of patients with other diagnoses also requiring inpatient care. A retrospective, matched case-control study of 51 patients with schizophrenia requiring psychiatric inpatient care was undertaken. A priori specified risk factors were investigated within the schizophrenia group and compared with those of patients with other psychiatric diagnoses. The results show that previous suicide attempts are associated with an increased risk of suicide across all diagnoses. The presence of depressive symptoms and involvement of police with the index admission become more significant factors in patients with schizophrenia, compared to those with other diagnoses. Supportive mental health accommodation is associated with a reduced risk of suicide. Suicide of individuals is difficult to predict in patients with schizophrenia. Young men appear particularly vulnerable at times of inpatient care. Depressive symptoms and previous suicide attempts are significant risk factors.     

Ante- and perinatal circumstances and risk of attempted suicides and suicides in offspring: the Northern Finland birth cohort 1966 study

Purpose

To investigate those ante- and perinatal circumstances preceding suicide attempts and suicides, which have so far not been studied intensively.

Methods

Examination of the Northern Finland Birth Cohort 1966 (n?=?10,742), originally based on antenatal questionnaire data and now followed up from mid-pregnancy to age 39, to ascertain psychiatric disorders in the parents and offspring and suicides or attempted suicides in the offspring using nationwide registers.

Results

A total of 121 suicide attempts (57 males) and 69 suicides (56 males) had occurred. Previously unstudied antenatal factors (maternal depressed mood and smoking, unwanted pregnancy) were not related to these after adjustment. Psychiatric disorders in the parents and offspring were the risk factors in both genders. When adjusted for these, the statistically significant risk factors among males were a single-parent family for suicide attempts (OR 3.71, 95% CI 1.62–8.50) and grand multiparity for suicides (OR 2.67, 95% CI 1.15–6.18). When a psychiatric disorder in females was included among possible risk factors for suicide attempts, it alone remained significant (OR 15.55, 8.78–27.53).

Conclusions

A single-parent family was a risk factor for attempted suicides and grand multiparity for suicides in male offspring even after adjusting for other ante- and perinatal circumstances and mental disorders in the parents and offspring. Mothers’ antenatal depressed mood and smoking and unwanted pregnancy did not increase the risk of suicide, which is a novel finding.