气质性乐观、生活事件与医学生自杀意念的关系研究

目的 在医学生中探讨气质性乐观、生活事件与自杀意念的关系.方法 采用自杀意念自评量表以及乐观问卷、青少年生活事件量表对两所医学院校的800名临床医学专业学生进行调查.结果 ①应激事件对医学生的自杀意念水平有正向预测作用,应激事件越严重,学生的自杀意念水平越高;②气质性系观对应激事件与自杀意念之间的关系具有调节作用.结论 气质性乐观是负性生活事件与自杀意念之间的调节器.     

脑梗死后抑郁与负性生活事件的关系及其抗抑郁治疗的研究

目的探讨脑梗死后抑郁与负性生活事件的关系及其抗抑郁治疗的效果。方法将162例脑梗死患者按是否受负性生活事件影响分为负性生活事件影响组(A组,85例)和无负性生活事件影响组(B组,77例);采用Zung抑郁量表(SDS)及汉米尔顿抑郁量表(HRSD)进行抑郁症筛查,并对两组进行对比分析;对确诊为脑梗死后抑郁症患者每日早晨服百忧解20mg,连续用药4周,观察其疗效。结果A、B两组抑郁的发生率分别为56·5%、36·4%,两组比较差异显著(P<0·05);百忧解治疗脑梗死后抑郁的总有效率为59·9%。结论脑梗死后抑郁的发生与负性生活事件相关;应用百忧解治疗脑梗死后抑郁有效。     

上海市中学生心理健康状况与生活事件之间关系的横断面研究(英文)

背景 在国内,学生的人口学特征及负性生活事件与其心理健康的关系尚未得到充分的研究。目的 评估中学生中各种生活应激事件的发生率,确定与中学生自我感知的心理健康问题密切相关的人口学特征和生活事件的类型。方法 采用分层随机抽样的方法进行横断面调查,抽取上海市2个区4所中学共1818名学生,应用2种自评问卷进行评估:长处与困难问卷(Strengths and Difficulties Questionnaire,SDQ)学生版和用于评估11项负性生活事件的简易版青少年生活事件量表(Adolescent Self-rating Life Events Checklist,ASLEC)。结果 中学生报告的常见负性生活事件为学习压力(74%),受到批评(66%),家庭冲突(29%)以及受人欺负、歧视或人际关系紧张(26%),但是这些事件的发生率因学生的性别、学校类型以及所处城郊位置不同而有所差异。同样,不同组别的学生其生活事件所致心理应激水平、心理困难总分以及社会行为水平亦有所不同。多因素线性回归分析表明,评估前6个月内心理困难的独立预测因素依次为(按照重要性先后顺序):过去一年内负性生活事件所致的应激总评分高,受人欺负、歧视或人际关系紧张,没有发生亲人死亡,男性,学校位于郊区,以及未患重病或残疾。社会行为水平的独立预测因素依次为负性生活事件所致的应激总评分高,学校位于城区,女性,普通中学(与重点中学比),受人欺负、歧视或人际关系紧张,没有发生亲人死亡,初中(与高中比)。结论 与中学生的应激和社会行为相关的众多因素之一是负性生活事件。进一步需要开展前瞻性研究以阐明中学生应激与负性生活事件的因果关系,开展并验证人群特异性的干预方法以减轻应激、增加适应性社会行为。     

The InterSePT scale for suicidal thinking reliability and validity

BACKGROUND: The InterSePT Scale for Suicidal Thinking (ISST) is a 12-item instrument for the assessment of current suicidal ideation in patients with schizophrenia and schizoaffective disorders. We report the psychometric characteristics of this new scale based on two studies. METHOD: In Study 1, 22 inpatients with schizophrenia and schizoaffective disorders, who had recently attempted suicide or engaged in suicidal ideation, were rated by three trained independent raters to examine interrater reliability. In Study 2, a total of 980 patients with schizophrenia or schizoaffective disorder with a history of suicidal ideation in the past 36 months were enrolled in a 2-year industry-sponsored suicide prevention study. At baseline, these patients were administered the ISST and the Clinical Global Impression Scale for Severity of Suicidality (CGI-SS) by the Principal Investigator (PI) and by a blinded rater (BR), who also administered the Positive and Negative Symptom Scale (PANSS), the Calgary Depression Scale (CDS), and the Scale of Functioning (SOF). Indices of internal reliability, construct and discriminant validity were examined. RESULTS: The intraclass correlation coefficient (ICC) for the total ISST score for the 22 subjects in Study 1 was 0.90 and mean weighted item kappa coefficients ranged from 0.66 to 0.92. In Study 2, internal reliability (Cronbach alpha) was high, ranging from 0.86 to 0.89 for the individual items, and the overall Cronbach alpha coefficient for all items was 0.88. The ISST (PI) total score was highly correlated with the CGI-SS by the blind rater (r = 0.61, p < 0.0001). ISST total scores significantly differentiated the different levels of CGI-SS (F = 519.2; p < 0.0001). Results of construct and discriminant validity analyses are also presented. CONCLUSION: The ISST is a reliable and valid instrument for the assessment of current suicidal thinking in patients with schizophrenia and schizoaffective disorder by both clinicians and researchers.     

The association between early life mental representations and suicidal behavior

The escalation of self-destructive acts among all age groups has motivated researchers to identify the factors that may contribute to suicidal behavior. Suicide has been attributed to numerous etiologic factors, including the presence of psychopathology (e.g., affective disorders), neuroendocrine dysregulation and genetic tendencies. Nevertheless, investigations have not identified the precise mechanism(s) by which self-destructive proclivities are generated. This paper proposes a developmental psychopathology model based on early life mental representations that would enable clinicians to chart an individual's susceptibility to suicide and to better anticipate when suicidal behavior could become activated.     

The baby alarm distress scale: a validity study

It should take into account the psychopatologic context and the child's development moment to evaluate the baby alarm distress from a standardized instrument. We present the BADS questionnaire validation by its application in 90 children, from 0 to 2 years-old, obtaining a K=0.783 to p<0.01, with a Spearman coefficient of 0.866 and factorial analysis to 4 factors to 63.5% of the population studied. With these psychometrical qualities, the scale shows its importance as a screening but is important its study in others populations.     

Conners教师评定量表的临床效度研究

目的　检验Conners教师用评定量表的临床效度。方法　将Conners教师用评定量表(TRS)应用于符合DSM Ⅳ注意缺陷多动障碍 (ADHD)标准的 5 7例ADHD儿童及同年龄、同性别的全国常模样本上海组儿童。结果　 (1)内容效度 :ADHD组的因子分及总分均高于对照组 (t=11 2 4 0～16 6 5 2 ,P <0 0 0 1) ;(2 )效标效度 :TRS对ADHD儿童的诊断灵敏度是 86 0 % ,特异度 94 7% ,诊断符合率 90 3% ;(3)结构效度 :各因子与总分的相关 (γ =0 892～ 0 974 )超过各因子之间的相关 (γ =0 6 93～ 0 96 3) ;经最大方差旋转后得出了 5个因子 ,有 3个因子与美国TRS的因子相似 ,即多动、注意力不集中、冲动 ,并产生了 2个不同于美国儿童的因子 :社交问题、被动。结论　Conners教师用评定量表适合于我国儿童注意缺陷多动障碍儿童的评估。     

TPH and suicidal behavior: a study in suicide completers

An association between the gene that codes for tryptophan hydroxylase (TPH)-the rate-limiting enzyme in the synthesis of serotonin-and suicidal behavior has been investigated with some detail in samples of living subjects who attempted suicide. In this study, we investigated TPH and suicide completion, the most severe form of suicidal behavior. A relatively large sample of suicide completers (n = 101) was genotyped at three TPH loci (two polymorphisms in the promoter region, A-6526G and G-5806T, and one in intron 7, A218C) and compared to psychiatrically normal living controls (n = 129). Although no significant differences were found between groups for genetic variation at single loci, haplotype analysis revealed that one haplotype (-6526G -5806T 218C) was significantly more frequent among suicide cases than in normal controls (chi(2) = 11.30, df = 2, P = 0.0008; OR = 2.0 CI: 1.30-3.6). Further analyses suggested that this haplotype is particularly more frequent among subjects who committed suicide using violent methods. Similar results were observed in recent haplotype analyses in suicide attempters, which found that the equivalent of haplotype -6526G -5806T 218C was more frequent in impulsive attempters (Rotondo et al, Mol Psychiatry 1999; 4: 360-368). Our results replicate in suicide completers previous data observed in suicide attempters. These and other results continue to point to the substantial role that the gene that codes for TPH may play in the neurobiology of suicidal behavior.     

Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients

Purpose  

Research of suicidal behavior in individuals with schizophrenia has often suggested that clinical characteristics and symptoms likely influence a patient’s suicidal risk. However, there is a lack of research describing the link between patients’ subjective quality of life (SQOL) and suicidal behavior in non-Western countries. Therefore, the current study attempts to explore how schizophrenia patients’ SQOL and their suicidal behavior are related in a Taiwanese sample.     

The relationship between adolescent suicidal behavior and life events in childhood and adolescence.

OBJECTIVE: Although the relationship between experience of problematic life events and adolescent suicidal behavior has frequently been recognized during the past decade, few studies of life events have been initiated that discriminated between adolescent suicide attempters and depressed adolescents. Therefore, the authors compared adolescent suicide attempters with both depressed and nondepressed adolescents who never attempted suicide with respect to life events that happened in two periods: childhood (defined as the period up to age 12 years) and adolescence (age 12 and older). METHOD: Using a semistructured interview, the authors gathered life event data about childhood and adolescence from three groups of adolescents: 48 suicide attempters, 66 depressed adolescents who had never made a suicide attempt, and 43 nondepressed adolescents who had never made a suicide attempt. RESULTS: The group of adolescents who attempted suicide differed from both of the other groups in that they had experienced more turmoil in their families, starting in childhood and not stabilizing during adolescence. During adolescence, they were more often sexually abused. During the last year before the attempt, further social instability, such as changes in residence and having to repeat a class, occurred. CONCLUSIONS: For suicidal adolescents, the suicide attempt seems embedded not just in the problems every adolescent has to deal with but in greater turmoil in their families, rooted in childhood and not stabilizing during adolescence, in combination with traumatic events during adolescence and social instability in the year preceding the attempt.     

Smoking and the risk of suicidal behavior: a prospective study of a community sample

BACKGROUND: A link between cigarette smoking and suicidal behavior has been reported in clinical and epidemiological studies. OBJECTIVE: To examine the association between smoking and suicidal thoughts or attempt in a longitudinal study, in which proximate status of smoking and psychiatric disorders in relation to timing of suicidal behaviors is taken into account. DESIGN: A longitudinal study of young adults interviewed initially in 1989, with repeated assessments over a 10-year follow-up. SETTING AND PARTICIPANTS: The sample was selected from a large health maintenance organization representing the geographic area, except for the extremes of the socioeconomic range. The response rate at each follow-up (3, 5, and 10 years after baseline) exceeded 91%. MAIN OUTCOME MEASURES: Relative risk of occurrence of suicidal behaviors during follow-up intervals by status of smoking and psychiatric disorders at the start of the interval, estimated by generalized estimating equations with repeated measures. The National Institute of Mental Health Diagnostic Interview Schedule was used at baseline and at each reassessment. RESULTS: Current daily smoking, but not past smoking, predicted the subsequent occurrence of suicidal thoughts or attempt, independent of prior depression and substance use disorders (adjusted odds ratio, 1.82; 95% confidence interval, 1.22-2.69). Additionally, current daily smoking, but not past smoking, predicted the subsequent occurrence of suicidal thoughts or attempt, adjusting for suicidal predisposition, indicated by prior suicidality, and controlling for prior psychiatric disorders (adjusted odds ratio, 1.74; 95% confidence interval, 1.17-2.54). CONCLUSIONS: The biological explanation of the finding that current smoking is associated with subsequent suicidal behavior is unclear. Recent observations of lower monoamine oxidase activity (which may play a role in central nervous system serotonin metabolism) in current smokers but not ex-smokers might provide clues, but interpretations should proceed cautiously.