某部新兵自杀未遂心理社会危险因素调查

目的 探讨新兵自杀未遂的心理社会危险因素.方法 采用多级整群抽样法随机抽取某部986名新兵,采用自编调查问卷、父母教养方式问卷、青少年生活事件量表和艾森克个性问卷进行调查.结果 2.1%曾有自杀未遂史,其中28.6%为反复自杀未遂.自杀未遂的原因以家庭矛盾居多.自杀方式以过量服药或服毒居多.自杀未遂的危险因素有生活事件、自杀行为家族史、父亲酗酒、家庭适应性、家庭经济困难、父亲过分干涉、受惩罚、父母离婚或再婚等.结论 自杀未遂在新兵中并不罕见,应认识其危险因素并积极进行干预.     

1994～2006年接诊自杀案例特征演变分析

自我伤害即若有结束自己生命为目的,则为自杀行为.国内每年有28多万人自杀死亡,200多万人自杀未遂[1].自杀未遂也是自杀死亡最重要的危险因素之一.为了了解自我伤害者尤其自杀行为者的有关特征及自杀行为年度变化趋势,作者对过去13年本院急诊科救治的自我伤害者相关信息进行回顾性分析,结果报告如下.     

抑郁症自杀未遂者的危险因素调查

目的探讨抑郁症患者自杀未遂的临床特征及危险因素。方法采用汉密尔顿抑郁量表与自编抑郁症自杀行为调查表,分别对149例抑郁症患者进行调查评分。结果65例(43.6%)患者出现过自杀未遂,自杀平均年龄为(39.2±15.1)岁,呈双峰分布;主要自杀方式依次为过量服药、割腕、自缢、溺水。单因素分析显示主要危险因素有年龄、病程、自杀家族史、负性生活事件以及绝望感、认识障碍、焦虑躯体化。结论抑郁症自杀未遂与生物心理社会因素有关,临床工作中应重视对其危险因素的评估和干预。     

抑郁症自杀未遂者的危险因素调查

目的 探讨抑郁症患者自杀未遂的临床特征及危险因素。方法 采用汉密尔顿抑郁量表与自编抑郁症自杀行为调查表，分别对149例抑郁症患者进行调查评分。结果 65例（43．6％）患者出现过自杀未遂，自杀平均年龄为（39．2&;#177;15．1）岁，呈双峰分布；主要自杀方式依次为过量服药、割腕、自缢、溺水。单因素分析显示主要危险因素有年龄、病程、自杀家族史、负性生活事件以及绝望感、认识障碍、焦虑躯体化。结论 抑郁症自杀未遂与生活心理社会因素有关，临床工作中应重视对其危险因素的评估和干预。     

归因分析青年期自杀未遂者的心理及心理干预

目的探讨青年期自杀未遂者的心理因素,从而有针对性地制定提高他们的心理素质和应激的能力的措施.方法对96例青年期自杀未遂者及家属进行心理调查.分为研究组和对照组,研究组48例给予常规护理的同时给予随防及心理干预,对照组48例只给予常规护理及随访.结果经过心理干预,2组青年期自杀未遂者道德、思维、认知、情感和意志行为等方面均有明显的差异,经统计学处理,p＜0.01.结论通过护理干预可提高青年期自杀未遂者的心理素质和应激能力.     

伴人格障碍自杀未遂者临床特点研究

为探讨伴人格障碍自杀未遂者的临床特点,对108名自杀未遂急诊入院的患者按CCMD-2-R进行人格障碍的诊断,分为伴人格障碍组和不伴人格障碍组,得到社会人口学资料和临床资料并进行自杀意图量表及自杀企图冲动性和致死性的测定,将有关项目作对比分析。结果,有40(37.04％)名自杀未遂者伴发人格障碍。与不伴人格障碍自杀未遂者比较,伴人格障碍自杀未遂者有较多的既往自杀未遂史和精神科治疗史,自杀意图和自杀企图致死性较低,冲动性较高。提示,对伴人格障碍自杀未遂者应给予特别对待和积极治疗。     

自杀未遂患者的心理因素分析及心理干预研究

目的探讨自杀未遂患者的心理因素,给予随访及心理护理干预,提高他们的生活质量。方法 96例自杀未遂患者随机分为研究组和对照组。研究组在住院时给予常规护理并随访1年及心理干预,对照组在住院时仅给予常规护理及1年后随访。两组在入组及结束时都做心理健康问卷、生活事件量表、应付方式问卷、生活质量综合问卷评定。结果结束时研究组自杀未遂者心理健康问卷各方面均有明显的改观,对照组自杀未遂者心理健康问卷各方面均无明显改观,经统计学分析,两组间各单项改善差异有显著意义,P0.01。结束时研究组的生活事件、应付方式、生活质量有明显改善。结论自杀未遂行为多由与家庭有关的生活事件及不成熟的应付方式引起。通过心理护理干预可明显改善自杀未遂者心理健康状况、减少生活事件频度和再自杀危险、改善其对生活事件的应付方式,提高了自杀未遂者的生活质量。     

44例服药自杀未遂者相关因素分析及心理护理对策

目的探讨心理护理对服药自杀未遂患者的作用。方法对44例服药自杀未遂者相关因素分析及采用心理护理对策。结果发现自杀与年龄、性别、文化程度、社会地位、个性缺陷、精神障碍、生活事件等有关，心理护理对服药自杀未遂患者效果良好。结论对服药自杀未遂者实施有效的心理护理十分重要。     

呼吸科重症监护病房病人自杀引发的思考

自杀是人类的悲剧,是由于社会、家庭、自身因素导致人心理失衡,从而采取一些极端的方式自行结束自己生命的行为。据统计,全球每年有100万人~120万人自杀死亡,世界上每40秒钟就有1人成功自杀,每3分钟有1人自杀未遂。调查显示,在中国659例自杀未遂者中,仅38%在自杀当时有精神障碍,许多自杀未遂者表现为冲动性自杀行为。对于自杀未遂者来     

急诊科153例自杀未遂者流行病学研究

目的了解急诊科自杀未遂者流行病学情况,为预防自杀和危机干预提供科学依据。方法采用描述性流行病学方法,分析上海市浦东新区公利医院急诊科153例自杀未遂者资料。结果急诊科自杀未遂者女性大大高于男性,男女比例为1：4．6,以青少年居多;自杀未遂者以初中文化水平居多;自杀未遂者的社会支持系统以家庭支持为主;自杀方式以服药居多;绝大部分自杀未遂患者未曾求助心理咨询。结论全社会应加强对青少年的心理健康教育,重视20—30岁的青年群体的心理健康状况,在文化水平不高的农村地区普及心理咨询知识,加强对于出售镇静催眠药和农药的控制。综合医院急诊科在对自杀未遂者进行危机干预的过程中起着相当重要的作用。     

Prevalence and associated factors of suicide among hospitalized schizophrenic patients

BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance abuse.However,there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts,such as medication and treatment.AIM To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia patients.METHODS This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or more.The outcomes and possible suicide risk factors in these patients were collated.The current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none(0 points),mild(1-8 points),moderate(9-16 points),or severe(17 or more points).This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic patients.RESULTS Of 228 hospitalized schizophrenia patients,214(93.9%)were included in this study.The majority(79.0%)of patients were males.Females appeared to have a slightly higher suicidality risk than males,with borderline significance.With regard to the current suicide risk assessed with the mini-international neuropsychiatric interview,172(80.4%)schizophrenic patients scored zero,20(9.4%)had a mild risk,8(3.7%)had a moderate risk,and 14(6.5%)had a severe risk.The total prevalence of current suicide risk in these schizophrenic patients was 19.6%.Based on multivariable ordinal logistic regression analysis with backward elimination,it was found that younger age,a current major depressive episode,receiving fluoxetine or lithium carbonate in the previous month,or a relatively higher Charlson comorbidity index score were all significantly and independently associated with a higher level of suicide risk.CONCLUSION The prevalence rate of suicide attempts in schizophrenia is high.Considering risk factors in routine clinical assessments,environmental manipulations and adequate treatment might prevent or decrease suicide in these patients.     

Risk of suicide: its occurrence and related variables among bereaved substance users

Background: Drug-dependent people are one of the most vulnerable populations to death by suicide. This study aims to explore the occurrence and related factors for risk of suicide in a sample of 196 bereaved substance-dependent patients.

Methods: Sociodemographic characteristics, bereavement and drug-related variables and symptoms of complicated grief (CG) were examined in a sample of 196 bereaved drug-dependent patients abstemious at least during the last month. A multiple linear regression analysis was adjusted to identify predictors of risk of suicide.

Results: 61.2% of patients reported risk of suicide. Those participants with risk of suicide were separated or widowed, without work, reported family antecedents of suicide attempts as well as personal suicide attempts and symptoms of CG.

Conclusion: Results indicate that the occurrence of the risk of suicide among drug-dependent people is very high and some risk factors are identified. Clinicians should pay particular attention to the bereaved drug-dependent patients with risk factors in order to identify people more vulnerable to present suicide risk.     

Factors that influence emergency department doctors' assessment of suicide risk in deliberate self-harm patients.

OBJECTIVES: To determine the patient factors influencing UK Emergency Department doctors' assessment of suicide risk. To establish whether immediate clinical management is consistent with perceived risk. METHODS: The Manchester and Salford Self-Harm project is a multi-centre deliberate self-harm monitoring study. Data collected were used to analyse risk assessments made by Emergency Department doctors between September 1997 and August 1999. We used univariate and logistic regression analyses to determine the factors Emergency Department doctors used to make suicide risk assessments. RESULTS: A total of 3220 deliberate self-harm assessment forms were completed in two years by Emergency Department doctors; 2922 (91%) included a clinical assessment of risk; 28 out of 48 variables were associated with perceived suicide risk. Multiple logistic regression analyses showed that current mental state, high suicidal intent (including medical seriousness of attempt), and male sex were the most important independent predictors of suicide risk. Being referred to psychiatric services directly from the Emergency Department or to surgical/medical services was also strongly associated with a perceived high risk. CONCLUSION: In contrast to the negative findings of previous research, we found that Emergency Department doctors were influenced by key risk factors for suicide in their assessment of deliberate self-harm patients. Emergency Department doctors' assessments reflected the immediate risk of suicide, indicated by factors such as current mental state and strong suicidal intent. Background risk factors such as social adversity and psychiatric history were less influential. We would recommend that training for emergency doctors should emphasize the importance of both immediate and background risk factors.     

Suicide risk among gay men and lesbians: A review

Without adequate death statistics from completed suicide data, the suicide risk for gay men and lesbians must be determined from empirical studies and from a theoretical understanding of suicide risk. Three large, well designed studies found that gay men and lesbians attempt suicide two to seven times more often than heterosexual comparison groups. Gay men and lesbians have significantly high rates of risk factors that increase suicide risk such as suicide attempts, alcohol abuse, drug abuse and interrupted social ties.

Durkheim suggests that groups with low social status and integration who are denied society's usual privilege and rights are at risk for alienation and anomic suicide unless protected by internal cohesion, religion or anlisuicide norms. Durkheim's theory applied to gay men and lesbians illustrates how the extensive and diverse alienation reported may lead to suicide. Diverse groups of gay people have not yet successfully decreased alienation or suicide.

Empirical evidence, risk factors and Durkheim's theory of anomic suicide thus supports the proposition that gay men and lesbians are at high risk for suicide. The need for sensitive research methodology, decreased heterosexual bias, creative network network sampling strategies, and confidentiality are discussed. Future research should clarify the completed suicide rates among diverse groups of homosexuals of different age, sex, race, and demographic variables.     

Assessing suicide risk in stroke patients: review of two cases

Poststroke depression can be accompanied by suicidal ideation, yet reports of suicide among stroke patients are rare. When untreated, depression can become prolonged and severe. Risk factors for suicide include depression, severe insomnia, chronic illness, and organic brain syndrome. Early clinical assessment of suicide risk factors is essential in the rehabilitation setting. Two patients who developed mood disturbances in the acute poststroke period and eventually committed suicide are presented. Neither patient openly expressed suicidal thoughts to staff or family members. Retrospective analysis of medical records was compared to established suicide risk factors reported in the medical literature. Indirect verbal cues and nonverbal behavior patterns indicating potential suicide risk may have been present. Strategies for evaluation and management of suicidal behavior are discussed. These cases emphasize the need for early assessment of suicide risk by the entire rehabilitation team.     

不同年代住院精神病患者自杀的相关因素及护理策略

目的 了解不同年代住院精神病患者自杀的相关因素,探索预防精神病患者自杀的护理策略.方法 回顾性调查1961～2000年住院精神病患者的自杀原因,并采用Logistic回归分析患者自杀的危险因素.结果 各种精神疾病患者自杀率差异无显著性(P>0.05);自杀与精神病理症状有关;既往有自杀史、负性生活事件、家庭成员有自杀史、病情严重、负性生活事件和社会支持不足,是住院精神病患者发生自杀的危险因素;治疗依从性好是患者自杀的保护因素;各年代自杀率呈下降的趋势(P<0.01).结论 做好风险评估和实施预见性护理,在控制病情的基础上加强监管等综合护理措施,有利于预防住院精神病患者自杀.     

不同年代住院精神病患者自杀的相关因素及护理策略

目的：了解不同年代住院精神病患者自杀的相关因素,以探索有效的预防精神病患者自杀的护理策略。方法：回顾性调查1961年～2000年32例不同年代住院精神病患者的自杀原因,并采用Logistic回归分析患者自杀的危险因素。结果：各种精神疾病患者自杀率差异无显著性（P〉0.05）;自杀与精神病理症状有关;既往有自杀史、负性生活事件、家庭成员有自杀史、病情严重和社会支持不足,是住院精神病患者发生自杀的危险因素;治疗依从性好是患者自杀的保护因素;各年代自杀率呈下降的趋势（P〈0.01）。结论：做好风险评估和实施预见性护理,控制病情,加强监护管理等综合护理措施,有利于预防住院精神病患者自杀行为。     

Adolescent Suicide: Assessment and Intervention

Understanding how to prevent suicide, the third leading cause of adolescent death, is the focus of this article. To prevent suicide, the nurse assesses risk factors, covert messages, overt suicide clues, and intervenes with the adolescent and family. Suicide risk and hopelessness decrease as suicidal youths learn to clarify problems, rally significant others, expand resources and use safe coping strategies. Interventions include a no-suicide contract, family therapy and school suicide prevention programs. Nurses can identify the youth at risk for suicide awl, in many cases, provide the therapy that helps prevent suicide. Vignettes illustrate strategies that effectively reduce suicide risk.     

护理干预在抑郁症伴有自杀行为患者中的应用

目的探讨护理干预在抑郁症伴有自杀行为患者中的应用效果。方法对10例抑郁症伴有自杀倾向患者进行风险评估、评估自杀高危因素、严格执行安全管理制度与保护制度、改变患者认知结构等。结果抑郁症伴有自杀倾向患者的自杀行为包括顿服大量药物、喝农药、割腕、溺水、自缢。患者自杀行为均被及时发现,自杀未遂。10例患者经治疗和护理均康复出院。结论对抑郁症伴有自杀行为患者实施有效的护理干预,可有效降低医疗风险和患者自杀的发生率。     

Traumatic brain injury and lifetime suicidality: Applying the interpersonal-psychological theory perspective

The present article investigates the traumatic brain injury (TBI)-suicide link, assessing whether (a) TBI accounts for variance in suicide risk, and (b) the interpersonal-psychological theory of suicide can be applied to TBI status. Matched case-control procedures applied to archival college student health data identified TBI and non-TBI subsamples (84 total). Individuals with a TBI possessed higher suicide risk than those without. Even accounting for the relative influence of strong suicide risk factors (i.e., depression, perceived burdensomeness, thwarted belongingness, and acquired capability), TBI was robustly associated with suicide risk. TBI history would be valuable to ascertain in assessing suicide risk.