中山市流动人口与户籍人口自杀率和自杀方式特征分析

目的分析2015年-2017年中山市流动人口和户籍人口自杀率变化趋势和自杀案例特征,为中山市制定自杀干预策略提供参考。方法抽取中山市死因登记报告信息系统中死亡时间为2015年1月1日-2017年12月31日的死亡案例,按照是否具有中山市户籍分为户籍组和流动组,计算并比较两组自杀率和自杀方式的差异。结果中山市2015年-2017年自杀率为4. 03/10万。户籍组和流动组年自杀率分别为3. 61/10万、4. 46/10万。两组自杀率均随年龄增长呈上升趋势,流动组60岁以上人群自杀率高于户籍组(34. 94/10万vs. 6. 83/10万)。前三位的自杀方式,户籍组分别为自缢[95例(53. 67%)]、服用农药[27例(15. 25%)]和高坠[22例(12. 43%)];流动组分别为自缢[65例(30. 37%)]、高坠[48例(22. 43%)]和服用农药[30例(14. 02%)],两组自杀方式分布的差异有统计学意义(χ~2=32. 99,P<0. 01)。结论中山市流动人口与户籍人口自杀死亡的案例均以自缢、服用农药和高坠为主。流动人口自杀率略高于户籍人口,老年流动人口可能是高自杀风险人群。     

自杀的国内外研究现状

自杀已成为近年来全世界精神卫生研究领域的重要课题之一,根据有关报道,1990年全球自杀死亡人数达140万,占该年总死亡人数的1.6％,而自杀或因意外死亡导致的伤残调整生命年(disability-adjusted life years,DALYs)损失为15.9％。表1归纳了近年来世界各国的自杀率,从中不难发现:自杀率和性别的差异在各国之间是非常显著的,一般男性高于女性(中国例外),目前男性自杀率最高的国家为前苏联解体后的立陶宛、俄罗斯联邦、拉托维亚和爱沙尼亚等(年自杀率>60/10万),而女性自杀率最高的国家为斯里兰卡、中国、匈牙利和爱沙尼亚等(年自杀率>14/10万)。而在部分     

大学生的自杀调查报告

调查南京23所大学1989～1991年在校学生自杀情况,结果发现共有33人自杀死亡。自杀率为16.22/10万,高于本市同期一般人口自杀率12.34/10万。其中男21人,女12人;以一、二年级较多。自杀主要原因为失恋、精神障碍、学习压力、前途失望、人际关系、家庭矛盾等。自杀方式以服药过量、自缢、溺水、坠楼为多。对大学生自杀同题应予重视,并提出预防措施。     

嘉峪关市自杀案例调查

目的：研究嘉峪关市自杀率、自然方式、自然原因等。方法：对嘉峪关市1975－1998年间城乡中所有自然死亡者资料作为调查研究对象，以CCMD－2－R标准确定诊断。结果：共调查348例，自杀率为15．59／10万人口，年龄以20－29岁为最多，自然方式以服毒为最常见，其次为自缢。自杀原因以婚恋及人际关系为主，其次为精神疾病。结论：该市自杀率较高，应引起重视。     

大中学生自杀意念及相关心理变量研究

目的:探讨大中学生自杀意念与相关心理变量的关系。方法:采用分层取样法,对某市初二到硕士研究生一年级828名被试进行自杀意念量表(SSI)等量表测试。结果:①随年龄增长,大中学生自杀意念、企图呈下降趋势。女生自杀意念比男生多,而男生自杀行为能力比女生强;②有无自杀意念者在临床症状、人格因素、应对风格及生活满意度上差异均有统计学意义;③自杀意念与症状自评量表(SCL-90)各分量表、艾森克个性问卷(EPQ)神经质、精神质、应对检查表(COPE)诸多应对风格显著相关。结论:大中学生自杀意念与临床症状、应对方式、人格和生活满意度存在相关。     

自杀研究在中国：自杀率的变化和理论探讨

在过去的几十年中,中国的自杀研究成果从无到有,研究团队由弱到强。中国大陆人口的自杀率在过去的这些年中经历了从高到低的快速变化,解释自杀和自杀率变化的理论也应运而生。本文总结了中国自杀研究近几十年的历史和现状,从经济和文化层面阐述了中国大陆自杀率急剧下降的原因,并采用自杀扭力理论系统地解释自杀和自杀率的变化的原因。     

1999-2015年天津市自杀死亡率变化趋势分析北大核心CSCD

目的了解1999-2015年天津市居民自杀死亡率及其变化趋势,探讨其在不同特征人群中的特点,为自杀的预防控制提供依据。方法采用天津市疾病预防控制中心收集的1999--2015年天津市居民全死因监测数据,统计天津市居民自杀死亡率,比较不同年龄、性别以及地区之间自杀死亡率的差异,并分析其变化趋势。采用2000年世界标准人LI计算年龄别、性别标化死亡率。采用Joinpoint回归和Cochran．Armitage趋势检验进行趋势分析。结果1999--2015年天津市自杀粗死亡率为4．76-4．07／10万。1999-2006年自杀标化死亡率为4．28-2．59／10万,呈下降趋势（Z=-9．37,P〈0．01）,年度变化百分比（annualpercentchange,APC）为-7．80％;2006-2015年自杀标化死亡率为2．59-3．00／10万,呈上升趋势（Z=2．15,P=O．032）,APC为1．54％。1999--2007年男性自杀标化死亡率为4．77～2．86／10万,呈下降趋势（Z=-7．43,P〈0．01）,APC为-6．89％;2007--2015年男性自杀标化死亡率为2．86-3．49／10万,呈上升趋势（Z=3．13,P=0．002）,APC为3．44％。1999--2006年女性自杀标化死亡率为3．79～2．04／10万,呈下降趋势（Z=-6．85,P〈0．01）,APC为-7．82％;2006--2015年女性自杀标化死亡率为2．04-2．50／10万,呈平稳趋势（Z=-0．16,P=0．871）。1999--2015年男性自杀标化死亡率总体高于女性。随着年龄升高,自杀死亡率逐渐升高。1999_之007年城市自杀标化死亡率为3．09～1．94／10万,呈下降趋势（z=-5．45,P〈O．01）,APC为-6．15％;2007-2015年城市自杀标化死亡率为1．94～2．44／10万,呈平稳趋势（Z=I．43,P=0．154）。1999-2005年农村自杀标化死亡率为5．65～3．03／10万,呈下降趋势（Z=-7．55,P〈0．01）,APC为-9．70％;2005--2015年农村自杀标化死亡率为3．03-3．73／10万,呈上升趋势（Z=2．69,P=0．007）,APC为1．71％。除2005年,农村各年份标化死亡率高于城市（P〈0．05）。天津自杀死亡方式前6位分别为自缢（32．09％）、服用农药（28．30％）、跳楼（12．88％）、自溺（8．87％）、服用药物（6．81％）和锐器伤（2．93％）。自缢为男性、城市最主要的自杀方式,服用农药为女性、农村最主要的自杀方式。女性自溺及服用药物自杀的比例高于男性（P〈O．05）。城市地区跳楼、自溺所占构成明显高于农村地区（P〈O．01）。结论1999-2015年天津市居民自杀死亡率呈1999-2006年明显下降,2006-2015年微弱上升的阶段性特点;男性自杀死亡率高于女性,农村高于城市;男女之间、城乡之间自杀死亡的方式不同。应根据人群不同特点,采取有针对性的干预措施,促进健康生活方式,加强自杀的一级预防,加强可预防自杀工具管理,加强自杀院前急救,减少自杀的死亡。     

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。     

从人生观看中国的自杀问题

所谓自杀问题有双层含义 :一是指自杀的现象 ,有多少人自杀 ,自杀率是多少 ,等等 ;二是指对自杀现象的评价、探讨和分析。中国目前的自杀率大约是 2 2 / 10万。据联合国有关机构规定 ,自杀率在 2 0 /10万以上即为自杀高危地区 ,可见 ,中国已属世界自杀高危地区。有专家指出 ,自杀虽然是一个严重的社会问题 ,但不是社会的阴暗面 ,因为自有人类以来 ,便存在着自杀现象 ;而现代经济高度发达的国家 ,也有高得惊人的自杀率。所以 ,我们应该也必须本着科学的态度 ,对中国的自杀现象进行深入地探讨 ,以期降低自杀率。如果说 ,动物的自杀主要是起因…     

城市居民自杀流行学研究

目的：了解城市居民的自杀流行学情况。方法：调查长沙市南区１９８７－１９９７年人群自杀的流行学特征。结果：长沙市南区人群１１年间平均自杀率为５．５／１０万。在１９９０－１９９７年８年间，自杀率有上升趋势（ｙ＝４．４７８＋０．６６４ｘ，Ｐ〈０．００１）。从自杀率的年龄分布看，存在两个高峰，２５－３４岁青年组及６５岁以上老年组，６５岁以上老年人自杀率（１８．３／１０万）为平均自杀率的３－４倍，男女自杀率     

Core features of suicide. Gender,age, alcohol and other putative risk factors in a low-incidence population

The aim of the study was to elucidate some supposed core features of suicide through a study of suicide in a low-incidence population. The material covered all suicides and undetermined deaths 1945–2004 in the Faroe Islands (a low-incidence population) and the study made use of all available information. Results showed that suicide rate had been low since the Second World War. However, there was an increase throughout the 1970s and 1980s. Supposed core features of suicide, such as gender, marital status, former psychiatric admittance, former suicidal behaviour, alcohol and method preference were confirmed. Others were not, such as an increasing rate with old age. In diagnostics, the role of psychiatric disorders was confirmed, but so was a substantial role of “no disorder”. Increase period revealed a high proportion of cases with alcohol involved and a substantial part included males, in age groups 25–64 years, unmarried, divorced and alcohol intoxicated. The main conclusion was that a low-incidence population of suicide population confirmed some supposed core features of the suicide phenomenon. Others, related to age and psychiatric disorders, were only partially confirmed. In periods of increase, the most vulnerable were the young and middle-aged males, unmarried, divorced, and alcohol played a crucial role.     

The gender difference in Chinese suicide rates

Chinese women have a higher rate of suicide than Chinese men in the regions of mainland China currently reporting mortality data to the World Health Organization. This gender difference is documented, and possible reasons for the gender differences are explored using data from a survey of female suicides in Chuanzhou County in the Guangxi region of China. A definitive explanation for the gender difference must await detailed psychological autopsy studies.     

DST non-suppression predicts suicide after attempted suicide

Most prospective studies of HPA axis have found that non-suppressors in the dexamethasone suppression test (DST) are more likely to commit suicide during the follow-up. Attempted suicide is a strong clinical predictor of suicide. The aim of this study was to assess the predictive value of DST for suicide in a group of depressed inpatients with and without an index suicide attempt. Historical cohort of 382 psychiatric inpatients with mood disorder admitted to the department of Psychiatry at the Karolinska University Hospital between 1980 and 2000 were submitted to the DST and followed up for causes of death. During the follow-up (mean 18 years), 36 suicides (9.4%) occurred, 20 of these were non-suppressors and 16 were suppressors. There was no statistically significant difference in suicide risk between the suppressors and non-suppressors for the sample as a whole. An index suicide attempt predicted suicide. In suicide attempters with mood disorder, the non-suppressor status was significantly associated with suicide indicating that HPA axis hyperactivity is a risk factor for suicide in this group. The dexamethasone suppression test may be a useful predictor within this population.     

The gender difference in chinese suicide rates

Abstract

Chinese women have a higher rate of suicide than Chinese men in the regions of mainland China currently reporting mortality data to the World Health Organization. This gender difference is documented. and possible reasons for the gender differences are explored using data from a survey of female suicides in Chuanzhou County in the Guangxi region of China. A definitive explanation for the gender difference must await detailed psychological autopsy studies.     

Month of birth and suicide: An exploratory study

OBJECTIVE: To explore the association between suicide and month of birth. METHOD: Data were extracted from records of the Public Health Department in North Cheshire between 1989 and 2000. &#164 Suicide' refers to all deceased who were the subjects of coroner's inquests resulting in a verdict of suicide or an open verdict. The month of birth of all who died of natural causes and were reported during a 2-year period was obtained from the Public Health Department in North Cheshire for comparison. RESULTS: There were 502 incidents of suicide in North Cheshire during the 12-year period. Significant differences were found between suicides and deaths due to natural causes, with an increase of incidents of suicide in those born in the month of May ( &#104 2 23, d.f.11, P < 0.01). The distribution of suicide by hanging appeared to be significantly higher in those born in September and July and lowest in those born in November compared with what would expected by chance ( &#104 2 28, d.f.11, P < 0.005). Those who died by violent means were more likely to have been born in the summer. The difference between the observed and expected numbers of suicides by methods other than hanging failed to reach statistical significance. CONCLUSION: The results, though inconclusive, are interesting, particularly in view of recent reports that persons born during the winter &#45 spring months had significantly lower values of 5-HIAA, and also reports of low CSF levels of 5-HIAA in persons with violent suicidal behaviour such as hanging, stabbing, firearms, or jumping from heights and impulsivity. A biological explanation of suicidal behaviour could have implications for our understanding of the psychopathology of suicide and eventually offer new strategies for treatment and prevention. The conflicting reports from different countries within the northern hemisphere indicate the need for future studies with adequate design and acceptable statistical power.     

Suicide risk and suicide method in patients with personality disorders

ObjectiveThe influence of psychopathology on suicide method has revealed different distributions among different psychiatric disorders. However, evidence is still scarce. We hypothesized that having a diagnosis of personality disorder (PD) affect the suicide method, and that different PD clusters would influence the suicide method in different ways. In addition, we hypothesized that the presence of psychiatric and somatic co-morbidity also affects the suicide method.MethodWe examined 25,217 individuals aged 15–64 who had been hospitalized in Sweden with a main diagnosis of PD the years 1987–2013 (N = 25,217). The patients were followed from the date of first discharge until death or until the end of the follow-up period, i.e. December 31, 2013, for a total of 323,508.8 person-years, with a mean follow up time of 11.7 years. The SMR, i.e. the ratio between the observed number of suicides and the expected number of suicides, was used as a measure of risk.ResultsOverall PD, different PD-clusters, and comorbidity influenced the suicide method. Hanging evidenced highest SMR in female PD patients (SMR 34.2 (95% CI: 29.3–39.8)), as compared to non-PD patients and jumping among male PD patients (SMR 24.8 (95% CI: 18.3–33.6)), as compared to non PD-patients. Furthermore, the elevated suicide risk was related to both psychiatric and somatic comorbidity.ConclusionThe increased suicide risk was unevenly distributed with respect to suicide method and type of PD. However, these differences were only moderate and greatly overshadowed by the overall excess suicide risk in having PD. Any attempt from society to decrease the suicide rate in persons with PD must take these characteristics into account.     

Decrease in suicide among the individuals treated with antidepressants: a controlled study of antidepressants in suicide,Sweden 1995–2005

Objective: Ecological studies have demonstrated a substantial decrease in suicide in parallel with an increase in the use of antidepressants. Causality cannot, however, be inferred from such studies. The aim of this study was to test on the individual level the hypothesis that treatment with antidepressant medication has been a substantially contributing cause of the decrease in suicide. Method: Time trends in the detection of antidepressants and five ‘control medications’ in the forensic toxicological screening of 16 937 suicides and 33 426 controls in Sweden 1995–2005. Results: The expected number of antidepressant‐positive suicides in 2005 was 409 if the hypothesis was true and 603 if it was false. The observed number in 2005 was 420. The control medications were detected to the extent that was expected if not preventing suicide. Conclusion: The observed trend in the number of suicides with antidepressants was well predicted by the hypothesis that the increased use of antidepressants has been a substantially contributing cause of the decrease in suicide.     

自杀未遂者出院后再次出现自杀行为的6年随访

目的 了解自杀未遂者再自杀情况及其影响因素.方法 对115例住院自杀未遂者出院后18个月、3年、5年、6年进行4次随访.结果 115例自杀未遂者中6年内21例再次出现自杀行为(18.3%),其中自杀死亡5例(4.3%).21例再次自杀者平均年龄(44.2±14.3)岁,13例有精神障碍(61.9%),8例既往(入院前)有自杀未遂史(38.1%),与94例无再次自杀行为者比较,两组在年龄(t=3.42)、精神疾病(χ2=11.20)、既往自杀未遂史(χ2=24.18) 方面的差异有统计学意义(均P<0.05).Logistic回归分析,仅既往自杀未遂史(P＜0.01,OR=10.21,β=2.32)进入回归方程.115例自杀未遂人群总的随访时间为723.55人年,以此推算6年内该组自杀未遂者群体年人均自杀死亡率为0.7%,年人均自杀未遂率为2.2%,年人均自杀行为率为2.9%.结论 部分自杀未遂者会再次出现自杀行为,而既往有自杀未遂史和有精神障碍的自杀未遂者更易再次发生自杀行为.     

有严重躯体疾病老年自杀死亡者的特征及其有无精神障碍者间的比较

目的了解有严重躯体疾病的老年自杀死亡者的特征并比较有无精神障碍者特征的异同。方法由精神科医师运用心理解剖方法对全国23个疾病监测点上报的≥55岁的304例自杀案例的家属和周围知情人进行调查,分析其中178例(58.6%)报告自杀死亡前1年内有严重躯体疾病者的自杀特征。结果178例自杀死亡者中,女性占41.6%;79.2%居住在乡村;58.4%从未上过学;38.8%丧偶;25.8%有自杀未遂既往史;10.7%一级血缘亲属有自杀行为;43.3%服农药或鼠药自杀,32.6%上吊;68.0%自杀当时有精神障碍,主要是重性抑郁障碍;仅5.1%自杀当时有人在场。有、无精神障碍者在社会人口经济学特征、有无自杀未遂史和自杀行为家族史、负性生活事件导致的慢性心理压力和急性应激强度以及自杀前一个月的生命质量等方面的差异无统计学意义(P均大于0.05)。结论有严重躯体疾病老年人自杀死亡最常见的两种方式是服毒和上吊,2/3有精神障碍,但有无精神障碍者的自杀相关特征无明显不同。     

军人自杀风险评估

本文旨在为建立军人自杀风险评估体系提供参考。军人自杀问题已引起各国军方的高度关注,自杀预防与干预的关键在于风险评估,但目前系统化的军人自杀风险评估理论与方法尚未形成。本文通过对各国军人自杀率、军人自杀的危险因素和自杀风险评估方法进行综述,为军队开展军人自杀风险评估工作提供新思路。