北京地区40家综合医院住院病人自杀意念和自杀未遂的调查

目的:了解北京地区综合医院住院病人自杀意念、自杀未遂的出现率及其危险因素。方法:采用自制抑郁筛选量表在随机抽取的北京40家各级综合医院中调查了2914例年龄>15岁的住院病人,了解他们自杀意念、自杀未遂发生情况及相关因素,并通过多因素logistic模型发现其危险因素。结果:2914例患者中,187人(6·42%;95%CI为5·58%~7·64%)有过自杀意念,其危险因素排列为:近一年感到绝望的频率高(OR=9·2,95%CI为6·5~12·9)、亲属有过自杀行为(4·3,2·3~8·3)、调查当时有重性抑郁发作(2·7,1·7~4·3)、熟人有过自杀行为(2·0,1·3~2·9)、年龄<55岁(1·7,1·2~2·3)、女性(1·5,1·1~2·1)。2914例患者中,25人(0·86%;95%CI为0·56%~1·26%)有过自杀未遂,其危险因素排列为:目前有重性抑郁发作(OR=5·6,95%CI为2·1~15·1)、亲属有过自杀行为(5·1,1·4~18·9)、近一年感到绝望频率高(4·7,1·9~11·9)、年龄<55岁(3·6,1·4~9·3)、女性(3·6,1·4~9·3)。结论:伴有抑郁症状的综合医院住院病人应视为自杀高危人群,需投入更多的关注。根据其自杀意念、自杀未遂的危险因素,应在综合医院制定和执行有针对性的自杀预防计划。     

高中生自杀态度的特征及其与自杀意念

目的研究高中生自杀态度的基本特点及其与自杀意念的关系。方法选用青少年自杀意念量表(PANSI)和自杀态度量表,对河南省1143名高中生进行问卷调查。结果 11143名高中生对自杀行为性质的认识(t=14.004)、对自杀者家属的态度(t=12.312)、对安乐死的态度(t=14.552)在家庭居住地上存在显著差异(P<0.05);2相关分析表明,自杀意念与自杀行为性质的认识、对自杀者家属的态度、对安乐死的态度呈负相关,其中对自杀者家属的态度负相关程度最高(r=-0.082,P<0.01);3线性回归分析显示,对自杀行为性质的认识、对自杀者的态度、对安乐死的态度3个因子能联合预测自杀意念的变异量6.1%的变异性。就个别变量的解释来看,以"对自杀行为性质的认识"的预测力最佳。结论高中生对于自杀态度及自杀意念在不同性别、不同家庭居住地差异上有统计学意义。自杀态度持肯定认同者,其自杀意念越强烈。     

儿童期虐待对中专学生自杀意念和自杀态度的影响

目的:探讨儿童期虐待对中专学生自杀态度和自杀意念的影响。方法:对符合入组标准的受虐待组学生和对照组学生各90名进行自杀态度问卷和自杀意念量表的测评,比较两组之间自杀态度和自杀意念的差异,并进行相关分析。结果:受虐待组学生在一周内及一年内自杀意念发生率分别为14·4%和32·2%,明显高于对照组学生(2·2%和14·4%,χ2=7·27、13·12,P<0·01);准自杀行为和自杀未遂行为发生率(15·6%)高于对照组学生(3·3%,χ2=6·50,P<0·05)。受虐待组学生对自杀行为、对自杀者及安乐死持肯定或理解态度者明显高于对照组(46·7%对18·9%,56·7%对35·6%);受虐待组学生对自杀越是持肯定态度,自杀意念也越强(r=0·38~0·55,P<0·01)。结论:儿童期虐待经历可使中专学生对自杀态度产生异乎寻常的变化,使受虐待者更容易产生自杀意念,发生自杀行为。     

浏阳市农村重性抑郁发作患者自杀意念与自杀未遂及影响因素分析

目的: 探讨农村社区重性抑郁发作患者中自杀意念与自杀未遂的阳性率及其影响因素.方法: 采用分层多级随机抽样方法调查浏阳市≥15岁农村常居居民7347人,以定式临床检查(Structured Clinical Interview-I/P,SCID-I/P)为诊断工具进行了抑郁症的筛查及诊断,共发现并确诊重性抑郁发作患者234人,均符合美国精神障碍分类诊断标准(DSM-IV),调查其社会人口学资料及相关危险因素情况.结果: 自杀意念与自杀未遂总阳性率达37.2%,女性高于男性(40.5% vs.31.4%,χ2=10.375,P=0.035).再婚、离异和丧偶者阳性率高于未婚或初婚者(50.0% vs.34.0%,Z=2.577,P=0.010).抑郁症的其他症状表现也与自杀意念和自杀未遂有关.多元logistic回归分析结果提示婚姻状况为再婚、离异或丧偶(OR=1.803,95%CI:1.220～2.532)和无价值感或自罪感症状阳性者(OR=2.056,95%CI:1.139～3.711)自杀意念和自杀未遂发生率较高,兴趣或愉快感缺失症状阳性与自杀意念和自杀未遂呈负相关(OR=0.397,95%CI:0.185～0.851).结论: 重性抑郁发作患者的自杀意念与自杀未遂阳性率较高,性别和婚姻状况对自杀意念与自杀未遂有影响,抑郁症的其他症状表现如无价值感或自罪感和自杀意念和兴趣或愉快感缺失也与自杀未遂有密切关系.     

抑郁症自杀行为的相关危险因素临床分析

目的　研究抑郁症自杀行为的危险因素 ,为预防自杀提供依据。方法　按 CCMD— 3诊断标准收集 2 1 1例住院的抑郁症患者 ,采用多因素 Logistic回归分析与抑郁症自杀行为有关的危险因素。结果　抑郁症自杀未遂 68例 (3 2 .2 % ) ,自杀与绝望 (相对危险度 RR=9.3 1 0 )、负性生活事件 (RR=3 .844)、自杀家族史 (RR=3 .62 7)、妄想 (RR=3 .783 )及自责 (RR= 2 .985 )呈正相关 (P均 <0 .0 1 )。结论　绝望、负性生活事件、自杀家族史、妄想及自责是抑郁症患者自杀的危险因素。     

湖南某县农村老年人的自杀行为

目的:探讨农村社区老年人自杀行为发生现况及其相关因素.方法:采用分层、整群、随机抽样方法,抽取衡阳县1040名≥60岁的农村社区老年人,应用自行编制的一般人口学资料调查表、自杀行为调查表、病人健康问卷抑郁量表( PHQ-9)、老年人生活事件量表(LESE)进行调查.结果:样本中最近一年自杀意念发生率为21.5％,自杀计划的发生率为5.5％,自杀准备的发生率为2.2％,自杀未遂的发生率为0.8％;将相关因素纳入非条件logistic回归模型,结果显示与自杀行为相关的因素为自评健康状况差(OR =1.43)、负性生活事件刺激量较大(OR =3.18)、抑郁筛查阳性(OR =20.01).结论:本研究显示衡阳县农村社区老年人自杀行为发生率较高,自评健康状况差、负性生活事件刺激量较大、抑郁筛查阳性可能是农村老年人自杀行为发生的独立危险因素.     

精神分裂症患者自杀原因对照研究

目的：从社会支持、精神症状、个性特征等方面探讨精神分裂症患者的自杀原因，为预测和预防精神分裂症患者的自杀行为提供依据。方法：采用早年（１８岁以前）不良家庭环境问卷、社会支持量表（ＳＳＲＳ）、明尼苏达多相人格调查表（ＭＭＰＩ）等工具，对３１例自杀未遂的精神分裂症患者和３３名对照者进行研究。结果：精神分裂症患者自杀组的抑郁症状、偏执型、早年不良家庭环境、自杀前自杀意念的分布明显高于非自杀组，且ＭＭＰＩ的依赖性量表分高而疑病分低。结论：抑郁症状、精神分裂症偏执型、早年不良家庭环境和ＭＭＰＩ的依赖性量表分高可以预测精神分裂症患者的自杀行为     

抑郁症患者的抑郁状态与自杀意念

目的探讨抑郁症患者抑郁状态与自杀意念的关系。方法采用贝克自杀意念量表中文版(BSI-CV)与汉密顿抑郁量表(HAMD)对352名抑郁症患者进行调查。结果抑郁症患者的抑郁总评分为(18.80±8.06);抑郁与自杀意念,特别是抑郁各因子中认识障碍与自杀意念强度(r=0.292,P<0.01)、自杀危险程度(r=0.336,P<0.01)呈显著正相关,阻滞与自杀意念强度(r=0.243,P<0.01)、自杀危险程度(r=0.267,P<0.01)呈显著正相关,绝望感与自杀意念强度(r=0.267,P<0.01)、自杀危险程度(r=0.289,P<0.01)呈显著正相关。结论抑郁因子中认识障碍、阻滞及绝望感与自杀意念呈显著正相关。     

北京市心理援助热线青少年来电者自杀意念的危险因素

目的:探索心理援助热线青少年来电者自杀意念的危险因素。方法:2018-2021年北京市心理援助热线的青少年来电者(11～18岁)纳入本研究,收集人口学资料,询问来电者在来电前2周内是否有自杀想法来评估自杀意念,并评估自杀相关的危险因素,如抑郁情绪、希望感、痛苦感等。采用logistic回归分析,探索青少年来电者自杀意念的危险因素。结果:本研究共纳入19 341例来电。77.9%(15 072例)青少年来电者报告该次来电前2周内有自杀意念。女性(OR=1.12,95%CI:1.01～1.24)、年纪轻(OR=1.30,95%CI:1.14～1.49)、有急性生活事件(OR=1.34,95%CI:1.23～1.47)、慢性生活事件(OR=1.31,95%CI:1.19～1.44)、既往自杀未遂史(OR=2.61,95%CI:2.35～2.91)、痛苦感高(OR=1.85,95%CI:1.67～2.04)和抑郁程度高(OR=2.71,95%CI:2.43～3.01)是青少年来电者自杀意念的独立危险因素,而高希望感(OR=0.45,95%CI:0.41～0.50)则是青少年来电者自杀意念的保护...     

抑郁症患者自杀态度与自杀意念的关系研究

目的探讨抑郁症患者自杀态度与自杀意念的关系。方法采用自杀态度问卷(Q SA)和B eck自杀意念量表中文版(BS I-CV)对334名抑郁症住院患者进行调查。结果抑郁症患者自杀态度的4个因子均分都在2.5~3.5之间;其与自杀意念强度、自杀危险程度呈一定负相关关系(P<0.05);结构方程模型拟合表明,自杀态度通过自杀意念强度影响自杀危险程度(近1周:χ2=2870.04,P<0.05,NNF I=0.88,CF I=0.89;最消沉抑郁时:χ2=1599.41,P<0.05,NNF I=0.94,CF I=0.95);在"近1周"和"最消沉"2个时间段,自杀态度对自杀危险程度的间接影响作用分别为0.308和0.410,P<0.05。结论自杀态度通过自杀意念强度对自杀危险产生影响。     

Suicidal ideation and suicide attempts among child and adolescent psychiatric inpatients in Finland

BACKGROUND: The aim was to study the prevalence of, and factors associated with, suicidal ideation and suicide attempts among child and adolescent inpatients during hospital treatment. METHODS: The target group included all the child and adolescent psychiatric inpatients (n=504) in Finland on a chosen day. Suicidality was determined by the psychiatrist responsible for the inpatient treatment, using a questionnaire also exploring demographic, diagnostic, and treatment characteristics, as well as traumatic events of the patient. RESULTS: The rate of suicidal ideation was 37.6%, and suicide attempts 10.8%. The factors independently associated with suicidal ideation in multivariate analysis were the following: being affected by open adult sexual behaviour (OR 3.2), having depression (OR 2.5) or conduct disorder (OR 2.4) diagnosis, and manifesting violent acts (OR 2.4). The factors independently associated with suicide attempts were: manifesting violent acts (OR 8.1), having depression diagnosis (OR 5.3), being affected by open adult sexual behaviour (OR 4.9), involuntary treatment (OR 4.7), and being of the female sex (OR 3.7). Suicidal ideation was particularly prevalent among boy patients having conduct disorders, manifesting violent acts, and belonging to the age group under 13 years old. Suicide attempts were particularly prevalent among depressive adolescent girl patients. LIMITATIONS: Suicidality was based solely on the clinician's evaluation. CONCLUSIONS: Suicidal ideation and suicide attempts are common among child and adolescent psychiatric inpatients. Particular attention should be directed to inpatients who manifest violent acts or have depressive disorder.     

Suicidal Behavior,Depression, and Hopelessness in Child Psychiatric Inpatients: A Replication and Extension

Examination of 55 consecutively admitted 6-to 13-year-old psychiatric inpatients indicated that 58% reported suicidal ideation and 40% had attempted suicide. Suicidal ideation was significantly associated with self-reports of hopelessness. Suicide attempts were significantly associated with both hopelessness and a diagnosis of depressive disorder, particularly major depression. Hopelessness and depression were highly correlated, and associations between Suicide attempts, hopelessness, and depression were accounted for partly by a group of hopeless depressed children. Thirty-six percent of suicide attempters had made prior attempts. This group of repeat attempters were older and had the highest rate of depressive disorders (75%). Whereas older (11- to 13-year-old) children tended to contemplate and attempt the same method, younger children tended to think of one method and attempt another, usually less lethal, method.     

Correlates of suicidal ideation in dysphoric mania

BACKGROUND: Previous investigations have reported that suicidal ideation and behavior are more prevalent during mixed than pure mania. Uncertainties exist about whether suicidality in mania arises from multiple concurrent depressive symptoms, or rather, as a categorical phenomenon, reflecting dysphoria without necessarily a full major depression. To elucidate the relationship between suicidal ideation and dysphoric mania, we analyzed clinical and demographic features associated with suicidal versus nonsuicidal dysphoric manic inpatients. METHODS: Records were reviewed for 100 DSM-III-R bipolar I manic inpatients at the Payne Whitney Clinic of New York Hospital from 1991-1995. All had > or = 2 concomitant depressive symptoms (other than suicidality). Affective and psychotic symptoms, past suicide attempts, prior illness, and related clinical/demographic variables were assessed by a standardized protocol. RESULTS: Suicidal ideation was significantly more common among dysphoric manics who were caucasian, took antidepressant medications in the week prior to admission, had histories of alcohol abuse/dependence, and made past suicide attempts. Suicidal ideation was evident for nearly half of dysphoric manic patients with < or = 3 depressive symptoms who did not meet DSM criteria for a mixed state. No individual manic or depressive symptoms other than dysphoric mood were more common among suicidal than nonsuicidal patients. LIMITATIONS: Findings from this retrospective study require confirmation using a prospective assessment. Treatments were naturalistic and may have differentially influenced hospital course and illness characteristics. Factors related to suicide attempts (rare in this cohort) or completions (not a focus of this study) may differ from those related only to suicidal ideation. CONCLUSIONS: Caucasian dysphoric manic patients with past suicide attempts and substance abuse may have a significantly elevated risk for suicidality, even when full major depression does not accompany mania. Suicidality is a clinically important consideration in a majority of dysphoric manic patients.     

住院抑郁症患者自杀相关问题

目的 :探讨住院抑郁症患者自杀相关问题。方法 :调查 2 0 0 0年连续住院抑郁症患者 3 0 9例 ,记录自杀相关问题及相应临床资料。结果 :住院抑郁症患者出现自杀意念、自杀意图、自杀行为的比例相当高。女性病人自杀行为明显多于男性 ,而男性自杀行为的后果较女性更为严重。精神疾病家族史、自杀家族史均与自杀行为关系密切。终身自杀次数与病程、住院次数、总住院时间相关。结论 :住院抑郁症患者存在较多的自杀问题 ,特别对病程长、多次住院、具有精神疾病或自杀家族史者 ,更是自杀预防的重点人群     

Predictors of Treatment Response for Suicidal Youth Referred for Emergency Psychiatric Hospitalization

This study evaluated factors that predicted poor treatment response for 70 suicidal youth (ages 10 to 17 years; 67% African American) who received either multisystemic therapy (MST) or inpatient psychiatric hospitalization. Following treatment, suicidal youth were classified as either treatment responders or nonresponders based on caregiver or youth report of attempted suicide. Overall, female gender, depressive affect, parental control, caregiver psychiatric distress, and caregiver history of psychiatric hospitalization were associated with suicide attempts. However, controlling for other variables, only depressive affect and parental control predicted treatment nonresponse. These results suggest the need to adapt existing treatments for suicidal youth to better address problems relating to youth depression.     

Suicidal Ideation in Adolescent Psychiatric Inpatients as Associated With Depression and Attachment Relationships

Examined suicidal ideation in adolescent psychiatric inpatients as associated with depressive symptoms and attachment to mother, father, and peers. Fifty-nine adolescent psychiatric inpatients (25 male, 34 female) completed self-report measures of suicidal ideation, depressive symptoms, and attachment. Attachment to mother accounted for significant variation in levels of depressive symptoms and suicidal ideation. In addition, attachment to peers accounted for significant variation in suicidal ideation and girls' (but not boys') depressive symptoms. However, after adjusting for depressive symptoms, attachment variables failed to contribute additional variance in suicidal ideation. Self-reported depressive symptomatology remained the strongest predictor of suicidal ideation, regardless of its order in the regression analyses. Prevention and treatment efforts may focus on mother-adolescent attachment and peer attachment (particularly in girls) to reduce risk for depression and suicidal ideation.     

Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients

BACKGROUND: Psychosis in pediatric mood disorder patients may be related to suicidal ideation. Bipolar (BP) adolescents are at high risk of completed suicide. We examined whether pediatric BP patients with psychosis have a higher prevalence of suicidality than non-psychotic BP patients. Based on previous findings in adult BP patients, we predicted that pediatric BP patients with psychotic symptoms would have higher prevalence of suicidality, higher occurrence of lifetime psychiatric hospitalizations and worse current Global Assessment of Functioning Scale (GAF) scores compared to non-psychotic BP patients. METHODS: We studied 43 BP children and adolescents (mean age +/- S.D = 11.2 +/- 2.8 y, range = 8-17) who did (n = 17) or did not have (n = 26) a lifetime history of psychotic symptoms. Indicators of suicidality (thoughts of death and suicidal ideation, plans, and attempts), psychiatric diagnoses, psychotic symptoms, psychiatric hospitalizations and GAF scores were assessed with the K-SADS-PL interview. LIMITATIONS: Small sample size, cross-sectional study and exclusion of substance abuse comorbidity. RESULTS: Pediatric BP patients with a lifetime history of psychotic symptoms compared to BP patients without psychosis were more likely to have thoughts of death (100% versus 69.2%, p = 0.01), suicidal ideation (94.1% versus 42.3%, p = 0.001) and suicidal plans (64.7% versus 15.4%, p = 0.002). Occurrence of psychiatric hospitalization was higher in psychotic BP patients compared to non-psychotic BP patients (82.4% versus 46.2%, p = 0.018). CONCLUSIONS: Psychotic symptoms in pediatric BP patients are associated with suicidal ideation and plans, and psychiatric hospitalizations. Psychotic symptoms are a risk factor for suicidality amongst pediatric BP patients.     

Longitudinal trajectories and predictors of adolescent suicidal ideation and attempts following inpatient hospitalization

Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.     

A prospective study of thoughts of self-harm and suicidal ideation during the postpartum period in women with mood disorders

Individuals with mood disorders are at higher risk for self-harm and suicidal ideation than other psychiatric group. However, the risk of self-harm and suicidal ideation after pregnancy for women with mood disorders is unknown. This investigation assessed the prevalence of thoughts of self-harm and suicidal ideation during the 1-year postpartum period in women with major depressive disorder or bipolar II disorder. Data were collected between June 2005 and March 2010 from a convenience sample of women participating in a study on the course of mood disorders during pregnancy and postpartum. Participant diagnosis was confirmed using the Structured Clinical Interview for DSM-IV. Thoughts of self-harm were assessed using the Edinburgh Postnatal Depression Scale item 10 and suicidal ideation was assessed using the Hamilton Depression Rating Scale item 3. During the 1-year postpartum period, 16.97 % reported thoughts of self-harm while 6.16 % reported suicidal ideation. Further, those reporting thoughts of self-harm or suicidal ideation postpartum also reported higher levels of depression and hypomanic symptoms. We found that a number of women in our sample of women with a diagnosed mood disorder report experiencing thoughts of self-harm and suicidal ideation during the postpartum.