以学校为基础的自杀干预及其理论基础

自杀是危害青少年身心健康的危险行为,也是全球重要的公共卫生问题。2007年美国疾病预防控制中心调查显示,6.9%的美国高中生有过自杀未遂,自杀是美国10～19岁青少年第3位死亡原因[1]。在我国,自杀是15～34岁人群的第1位死亡原因[2];17.4%的初中生在调查前1 a内严肃地考虑过自杀,8.1%有过具体的自杀计划[3]。我国每年200万自杀未遂人口中有2/3处于15～34岁年龄段,且几乎没有接受过任何心[4]     

青少年自杀意念及其影响因素

自杀是指有自我意识、自行采取的导致自己死亡的行为,是一个人自愿地、故意地杀死自己的行为或情况,自杀是目前全世界普遍关注的公共卫生问题之一,在很多国家,自杀已成为居民前10位死因之一[1]。自杀是我国居民第5位死因,是15~34岁年龄段第1位死因[2]。研究表明,我国青少年（15~24岁）自杀率高居35个国家中的第2位,仅次于斯里兰卡[3]。     

青少年自杀与家庭干预

1990年全世界有 140多万人因自杀死亡 ,自杀未遂的人数则可能高达该数字的 10～ 2 0倍。在大部分提供有关自杀死亡数字的国家中 ,自杀是前十位死因之一。而在青少年中 ,它是前三位死因之一[1] 。1　流行特征青少年自杀是一个很重要的、并可能是日益增加的社会问题。据英格兰和威尔士统计 ,年龄在 15～ 2 4岁之间的青少年中自杀是第二常见的死因[2 ] 。在我国提供给世界卫生组织(ＷＨＯ)的自杀死亡数字中 ,我国青少年 (15～ 2 4岁 )的自杀率高居 35个国家中的第二位 (仅次于斯里兰卡 )。根据对我国疾病监测点部分资料 (1988～ 1992年 )进行分…     

南昌市高中生自杀意念现状及特征

高中生正处于青春期的发育阶段,是生理和心理经历最具挑战的时期之一.由于自身社会阅历和人生经验的限制,该群体对死亡的概念认识较为模糊.虽然近年来有数据显示,我国青少年自杀率有所下降,但自杀仍是我国青少年因伤害致死的第3位原因….自杀意念是自杀未遂和自杀死亡者早期的心理活动,是自杀行为实施前强有力的预测因素[2].研究表明,自杀意念的产生是一个连续性的心理变化过程,排除与生理因素有关的影响外,与个人和社会环境等多种因素有关[3].本研究于2015年6月抽取南昌市5所高中高一、高二的884名学生,通过问卷调查了解其自杀意念发生特征,探究自杀意念与其他危险行为之间的关系,为促进高中生心理健康、早期识别和预防青少年自杀行为提供科学依据.     

江苏省部分学生自杀行为及影响因素分析

随着疾病谱的变化，伤害已取代躯体疾病成为青少年的第一位死因。自杀相关行为是伤害中较为严重的一类，美国一项调查显示，10～24岁青少年死亡原因中71％来自4个方面，即车祸、其他非故意伤害、他杀和自杀。2008年江苏省参加了全国青少年健康相关行为调查，现将其中关于学生自杀相关行为调查资料进行分析，以期对制订相关干预措施提供依据。     

北京市某区青少年伤害相关行为的现况调查

青少年是意外伤害发生的高危人群,而意外伤害是导致青少年早死和失能的主要原因,溺水、交通事故、自杀和他杀是我国10至19岁青少年意外死亡的前4位原因。分析青少年意外伤害行为的流行特点,对于加强对青少年伤害预防与控制,促进青少年的健康管理工作具有重要的现实意义。我们拟以北京市某区青少年意外伤害调查数据为例,为青少年意外伤害相关行为干预措施提供依据。     

宜昌市青少年自杀与离家出走行为调查

自杀与离家出走是造成青少年伤害死亡的主要原因之一。1996—2000年上海市中小学生伤害的死因统计资料显示，自杀为第3位。自杀给家庭、社会、学校带来了极大的负面影响，离家出走反映了学生心理负担，增加了社会不安定因素。为了解宜昌市青少年相关危险行为的流行情况，宜昌市疾病预防控制中心于2005年开展了对全市青少年危险行为因素的现况调查，现将自杀倾向与离家出走的调查结果报道如下。     

一个令家长心惊的话题——自杀低龄化

不久前在北京结束的第三届中美精神病学术会议的一份资料显示,自杀已成为我国青少年死亡的第一位原因。更令专家震惊的是,青少年自杀呈明显的低龄化趋势。     

一个令家长心惊的话题——自杀低龄化

不久前在北京结束的第三届中美精神病学术会议的一份资料显示，自杀已成为我国青少年死亡的第一位原因。更令专家震惊的是．青少年自杀呈明显的低龄化趋势。     

青少年自杀行为及干预的研究

现代社会由于经济危机、失业率增加等原因,干预各国的自杀率呈逐年上升趋势,自杀已成为一个公共卫生问题。在许多国家,自杀已成为居民前10位死因之一,美国每2h有1名青少年自杀,2003年青少年因自杀导致的死亡人数超过艾滋病、肿瘤、心肺疾患、出生缺陷的总和。在我国,自杀是15～34岁青少年人群的第1位死因。因此,研究和预防青少年的自杀行为具有重要意义。     

湖北省麻城市1 984--2008年自杀死亡水平长期趋势分析

目的 探讨1984-2008年湖北省农村人口自杀死亡水平的特征及其长期变化趋势.方法 利用湖北省麻城市1984-2008年居民死因监测资料,回顾性分析不同性别、不同年龄人群的自杀死亡水平、自杀死亡占伤害的死因构成比及其变化趋势.结果 1984-2008年间该地人群的自杀死亡率呈下降趋势,自杀标化死亡率由1984年的113.29/10万降至2008年的20.11/10万,下降幅度为82.25%.自杀死亡占伤害死亡的构成比下降幅度不明显,自杀仍是该地人群伤害死亡的首要死因.自杀死亡者中,女性人数始终多于男性,女性所占的构成比在50%～60%之间波动;≥65岁老年人口所比例近年来明显增加,2008年老年人的构成比达46.81%.结论 自杀仍居该地人群,特别是女性人群伤害死因谱的首位.农村地区自杀预防的重点人群是女性和≥65岁老年人.

Abstract：

Objective To explore the characteristics and the long-term trend of suicidal deaths among the rural population in Hubei province. Methods Data on suicide deaths from 1984 through 2008 were released from Macheng Death Registration System and analyzed by year, gender and age. Results The suicidal death rates were decreasing during the last 25 years in Macheng city, with the standardized suicide mortality rapidly decreasing from 113.29/100 000 in 1984 to 20.11/100 000 in 2008. The proportion of suicide deaths in the total deaths caused by injuries were declining but not obviously. Suicide was still the leading cause of deaths among all the deaths due to injuries.Number of suicidal deaths among females was outnumbered the males during the last 25 years,representing 50%-60% in total suicide deaths annually. The proportion of suicide deaths among the elderly aged 65 and over had significantly increased in the recent years, which accounting for 46.81% of all the suicidal deaths in 2008. Conclusion Suicide remained the leading cause of injury deaths among the population in this area, especially in females. Attention should be paid to the females and the elderly aged 65 and over,in the rural areas.     

A comparison of suicide and non-suicide deaths involving psychotropic drugs in four major U.S. cities.

By use of a standard reporting form, extensive data were gathered on 651 deaths involving psychotropic drugs and recorded with the Coroner's or Medical Examiner's Office in each of four major U.S. cities. Thirty-six per cent of these deaths were listed as "Definitely Suicide" and 44% were listed as "Non-Suicide." A comparison was made of the age, sex, race, occupational category, and type of drug involved for each of these two groups, by city. In general, the Suicide group tended to be older, from higher occupational levels, and more often female. Blacks were under-represented among the Suicides but over-represented among the Non-Suicides. Suicide deaths tended to be associated with barbiturates, analgesics, and/or sedatives, while the Non-Suicides usually died from an accidental abuse of narcotics, usually heroin. These findings tended to be similar for each city, although some inter-city differences were noted.     

扬中市居民意外死亡原因分析及健康教育对策

分析江苏省扬中市居民的意外死亡原因,并据此设计健康教育对策。方法汇总来自扬中市卫生、公安、民政部门的有关居民意外死亡的资料,进行分析总结。结果自杀、淹死、交通事故死亡在扬中市居民的意外死亡中占很大比重。机械性窒息成为婴儿死亡的主要原因。结论降低居民意外死亡的健康教育应加强针对性。自杀应成为预防的重点,应加强游泳安全、交通安全的教育。     

At risk in two worlds: Injury mortality among Indigenous people in the US and Australia, 1990–92

This paper outlines the commonalties and unique differences in injury experience among the Indigenous people in the United States and Australia. Injury mortality rates among Indigenous people in the United States and Australia are approximately 2–3 times greater than rates for the non-Indigenous population in each country. Motor vehicle-related injuries accounted for one-third of the injury deaths for Native Americans and Australian Aboriginals. Suicide accounted for more deaths in Native Americans (15.5 per 100,000) than it did for Australian Aboriginals (11.1 per 100,000), whereas the injury death rate in Australian Aboriginals due to poisoning was almost twice that of Native Americans. Culturally appropriate interventions tailored to specific local settings and problems will be necessary to reduce injury mortality among Indigenous people.     

Homicides and suicides--National Violent Death Reporting System, United States, 2003-2004

Violent deaths claimed 49,639 lives in the United States during 2003, and the prevention of violent deaths is an integral part of the public health agenda. In 2003, CDC launched the National Violent Death Reporting System (NVDRS) to provide detailed information on the circumstances of violent deaths. The system can be used to develop and evaluate prevention policies, programs, and strategies at the national, state, and local levels. This report describes the analysis of violent deaths from seven states that participated in NVDRS in 2003, plus six additional states that participated in 2004. Homicide circumstance information revealed that most victims knew the suspects involved and that intimate partner conflicts continued to be among the most important contributing factors. Suicide circumstance information indicated that mental health disorders and intimate partner problems had important roles. These findings underscore the value of NVDRS data for effective planning and targeting of violence-prevention programs.     

Does young adult suicide cluster geographically in Scotland?

BACKGROUND: Suicide rose dramatically among young adults in Scotland between 1980-1982 and 1999-2001, especially among those living in deprived areas. OBJECTIVE: To determine whether there are statistically significant geographical clusters of suicide and undetermined deaths among those aged 15 to 44 years in Scotland, and whether these persist through time. METHODS: Deaths from suicide and undetermined causes by young adults in Scotland for three periods-1980 to 1982, 1990 to 1992, and 1999 to 2001-were aggregated into 10,058 small areas for Scotland. Tests for significant (p<0.05) geographical clustering of suicide were carried out for each period separately. Methods of suicide inside the identified clusters were compared with those in the rest of Scotland. RESULTS: A significant geographical cluster of suicide among young adults was identified in east Glasgow in all three time periods (involving 92, 159, and 245 cases). Compared with the rest of Scotland, significantly more deaths in these clusters were caused by poisoning from liquids or solids over the entire period, but this was not the case in the most recent period (1999 to 2001). All three clusters could be explained by the concentration of socioeconomic deprivation in this part of Scotland. CONCLUSIONS: One interpretation of this large, persistent, and statistically significant cluster of suicides among young adults in east Glasgow is that suicide is geographically contagious, but the present results suggest that it is explained by the concentration of deprivation in this area. Suicide prevention strategies targeting at-risk populations living in east Glasgow are necessary to reduce the suicide burden in Scotland.     

Suicide among nursing home residents: a population-based study

OBJECTIVE: The rate of suicide is highest among the oldest old and is associated with chronic medical illness and functional impairment. These risk factors are prevalent among nursing home (NH) residents, yet little has been published on suicide in this population. METHODS: We performed a population-based, retrospective cohort study to identify clinical features of NH residents attempting or completing suicide. A computerized data-base search was conducted to identify cases of completed suicide in Olmsted County and surrounding communities (846 NH beds) between 1981 and 1997. Subjects' medical records were reviewed to identify clinical details. RESULTS: Five cases of completed suicide and three suicide attempts were identified, including six men and two women. Deaths were the result of drowning, hanging, or medication overdose (the latter following a period of intentional hoarding). Those who died ranged in age from 69 to 87 years. Most had been NH residents for less than 6 months. No deaths occurred in patients with severe cognitive impairment. CONCLUSIONS: Suicide and suicide attempts in the NH seem to be uncommon but are likely underrecognized and underreported. Suicide risk among NH residents seems to be highest among men and those recently admitted to facilities. In addition, suicide methods differ among NH residents compared with community-dwelling older people, likely reflecting environmental restrictions and physical limitations. Suicide and suicide attempts are important resident health issues and risk management concerns for staff in long-term-care facilities.     

上海市静安区1975-2014年户籍人口自杀死亡情况分析

目的 探讨1975-2014年上海市静安区户籍人口自杀死亡的流行情况,为提早预防和干预提供参考依据。方法 利用静安区1975-2014年居民死因监测资料分析自杀死亡占伤害的死因构成比,不同性别、不同年龄的自杀死亡水平差异以及1975-2014年自杀死亡水平的变化趋势。结果 1975-2014年静安区自杀死亡总数为1104例,占伤害的死因构成比为15.06%,位居伤害死因第2位;男性平均自杀粗死亡率为6.84/10万,女性平均自杀粗死亡率为6.67/10万,差异无统计学意义;在自杀死亡的人群中,15~44岁组和≥65岁组所占的比例较大,分别占36.32%和43.93%,且≥65岁组老年人的自杀死亡率较高(17.42/10万);1975-2014年自杀死亡率的长期趋势分析呈逐年下降的线性趋势;用SAS系统中的自回归过程进行时间序列线性趋势拟合,回归模型有意义(t=-8.72,P<0.01)。结论 政府和社会仍应高度重视自杀的预防,且预防控制的重点为老年人群。     

Temporal variation in suicide and homicide.

In this study of all of the violent deaths in the US over two years, clear monthly and daily variations were found. Suicide peaked in the Spring and Fall; homicide in July and December. Suicide was more common on Mondays; homicide on Saturdays and Sundays. Homicide was more common on national holidays, while suicide tended to be less common. No lunar variation was found.     

Mortality among women Vietnam veterans, 1973-1987

A retrospective cohort mortality study was conducted to examine health effects of US military service in Vietnam on women veterans who served there between July 4, 1965 and March 28, 1973. About 4,600 women Vietnam veterans and 5,300 women veterans who had never served in Vietnam were identified from military records and followed for vital status on December 31, 1987. Mortality rates for all causes of death combined and for all cancers among Vietnam veterans were similar to those among non-Vietnam veterans (relative risk (RR) = 0.93). There was a slight excess of mortality from external causes among women Vietnam veterans compared with non-Vietnam veterans (RR = 1.33), primarily due to an excess of motor vehicle accidents (RR = 3.19). Suicide rates were nearly the same in both cohorts (RR = 0.96). Vietnam veterans had twofold increases in mortality from cancers of the pancreas and uterine corpus compared with non-Vietnam veterans. Women Vietnam veterans and non-Vietnam veterans had lower-than-expected mortality from all causes of death combined (standardized mortality ratio (SMR) = 0.82 and 0.88, respectively), based on rates for US women, due to significant deficits of deaths from circulatory diseases. Compared with rates for US women, mortality from cancers of the pancreas (five deaths, SMR = 3.27) and uterine corpus (four deaths, SMR = 4.05) was significantly elevated among Vietnam veteran nurses.