大学生自杀意念及行为因素的相关分析

目的 分析在校大学生自杀意念的发生状况,探讨自杀意念及自杀行为的影响因素.方法 采用自制的调查表,以随机整群抽样的方法对520名在校大学生进行调查,并进行单因素和多因素Logistic回归分析.结果 大学生自杀意念的发生率为21.5%,进行过自杀的有15.8%.多因素的Logistic回归模型分析显示:自杀意念发生有关的主要危险因素是:家庭成员的支持、家庭和睦程度、与他人的关系等.结论 自杀意念及自杀行为与其影响因素联系密切,应根据其影响因素予以积极干预,从而减少自杀行为的发生.     

深圳市青少年自杀意念及相关因素分析

目的 了解中学生自杀意念的现状,探讨自杀意念产生的原因,为自杀的早期识别和干预提供理论依据.方法 采用分层整群随机抽样的方法 ,对深圳市14所中学4 950例在校学生,使用自杀行为问卷(SBQ-R-RC)、Beck绝望量表(BHS)、Beck抑郁量表(BDI)、家庭环境量表进行调查.并对自杀意念产生的影响因素进行分析.结果 深圳市青少年自杀意念发生率为34.48%,高中生自杀意念的发生率高于初中生(P＜0.001),女生高于男生(P＜0.001).影响自杀意念的主要因素包括情感表达、矛盾性、独立性、组织性、对未来的感觉和抑郁.结论 青少年自杀意念的发生率较高,特别是女生和高中生,且与社会心理因素密切相关,应当引起学校、家庭和社会的足够重视.     

农村老年人饮酒与自杀意念

目的:了解农村老年人自杀意念的影响因素,探讨饮酒与自杀意念的关系。方法:调查839名农村老年居民,用自编社会人口学问卷、酒精使用障碍筛查量表、病人健康问卷抑郁量表中文版、自编自杀行为量表收集资料。结果:危险饮酒和非危险饮酒农村老年人自杀意念差异无统计学意义;农村老年人抑郁状况与自杀意念存在相关性。结论:抑郁状况是农村老年人自杀意念的危险因素,但研究并未发现存在危险饮酒行为的老年人具有更高的自杀意念。     

抑郁症伴自杀意念患者的心理护理

抑郁症是一种常见的心境障碍,抑郁症患者是自杀的高危人群[1]。有研究显示,住院抑郁症患者中自杀问题严重,其中76.3%有过自杀意念[2]。自杀意念是指具有自杀的想法或倾向,不涉及自杀行为,当自杀意念较强时可导致自杀行为[3]。因此,应予以积极的评估及采取有效措施干预。有效的心理护理干预不失为预防抑郁症自杀的措施之一[4]。为探讨心理护理对抑郁症疗效及自杀意念的影响,作者对102例抑郁症伴自     

某边防部队士兵自杀意念调查及影响因素分析

<正>目前,有关中国军人自杀意念的文献报道较少。为了解边防军人自杀意念以及影响因素,笔者于2009-10对某边防部队的1478名士兵进行了调查,现将基本情况报告如下:1对象与方法 1.1对象随机选择某边防部队的1478名士兵作为调查对象,其中当年入伍新兵768名,老兵692名,均为男性,年龄18²9岁,平均(21.32±2.40)岁,军龄129岁,平均(21.32±2.40)岁,军龄1¹1岁,平均     

有自杀倾向抑郁症患者原因分析及护理对策

目的进一步提高对抑郁症患者自杀行为相关因素的认识，为临床护理提供帮助。方法对40例住院抑郁症患者分成有自杀意念行为组和无自杀行为组，将可能与自杀有关的因素行为作为观察指标进行分析。结果妄想，失眠和病程在自杀行为组和无自杀行为组中，自杀危险度相差很大。结论妄想、失眠早醒和病程长的抑郁症患者易发生自杀，正确的治疗和护理，是防范意外的有效措施。     

强制戒毒者的成瘾程度与抑郁状况和自杀意念的相关分析

目的：探讨抑郁情绪与吸毒人群自杀意念和成瘾程度之间的关系,并为进一步认识该人群的自杀行为提供依据。方法：对甘肃省兰州市榆中县强制戒毒所中的强制戒毒人员,采用随机抽样,使用阿片成瘾严重程度量表及自杀意念自评量表和抑郁量表,采取各大队各班抽测方式进行调查。结果：共157名调查对象的问卷有效,抑郁状况为成瘾程度和自杀意念产生的中介变量。结论：强制戒毒者的抑郁程度、自杀意念的发生率都远高于一般人群。成瘾和抑郁情绪的严重程度都可作为强制戒毒者自杀意念出现的重要评定因子。     

顺德区中学生自杀意念及其影响因素分析

目的 了解本地区中学生自杀意念发生率及其影响因素,为学生心理保健提供依据.方法 采用分层、随机抽取的本地区的1245例中学生为调查对象进行现况调查.自杀意念的评定根据症状自评量表的90个项目中第15项"想结束自己的生命"项.结果 发现有自杀意念者占6.43%.成绩满意度、与父母关系、特殊嗜好、父母之间关系、就读学校类型、家庭主导地位与自杀意念有关联.结论 中学生的自杀意念发生率较高,与多项因素有关,应加强对中学生的心理健康教育.     

边缘型人格障碍患者自杀意念危险因素研究

目的:探讨边缘型人格障碍(BPD)患病率及BPD患者发生自杀意念的危险因素。方法:对1 400例精神卫生科就诊的住院患者采用一般社会特征调查问卷、人格障碍诊断、自杀意念筛查问卷、汉密顿抑郁量表、儿童不良家庭环境调查表进行评定。结果:BPD 211例(15.07%),男63例(29.86%),女148例(70.14%)。BPD患者中158例(74.88%)存在自杀意念。BPD患者发生自杀意念的影响因素为性别、抑郁症共病、母子关系、父子关系。结论:BPD在精神卫生科住院患者中女性患病率高于男性,性别、抑郁症共病、儿童期不良家庭环境是BPD患者发生自杀意念的危险因素。     

抑郁症患者自杀相关问题的研究

目的探讨抑郁症患者自杀的相关问题。方法调查80例门诊及住院治疗的抑郁症患者,记录自杀相关问题及相应临床资料。结果抑郁症患者出现自杀意念、自杀意图、自杀行为的比例分别为78.7%、52.5%和27.5%。女性患者自杀行为明显多于男性。精神疾病家族史、自杀家族史均与自杀行为关系密切。结论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。     

Patterns and correlates of attempted suicide by heroin users over a 3-year period: findings from the Australian treatment outcome study

In order to determine patterns and correlates of attempted suicide amongst heroin users across 3 years, a cohort of 387 heroin users (134 entering maintenance treatment, 134 entering detoxification, 81 entering residential rehabilitation and 38 not entering treatment) were interviewed about suicide attempts at baseline, 12, 24 and 36 months. Across the follow-up period, 11.6% attempted suicide. There were declines in the proportion who attempted suicide each year amongst both males and females and significant declines in Major Depression, suicidal ideation and current suicide plans. Despite this, levels of attempted suicide, suicidal ideation and Major Depression in the cohort remained higher than in the general population. Those who had made a previous suicide attempt were five times more likely to make an attempt across follow-up and there was a strong association between an attempt in any 1 year and increased probability of an attempt in the subsequent year. A quarter of those who reported suicidal ideation at baseline made an attempt across follow-up. At each interview point, current suicidal ideation was strongly associated with increased risk of a suicide attempt in the following year. Independent predictors of a suicide attempt across follow-up were a lifetime suicide history, baseline suicidal ideation, social isolation and the extent of baseline polydrug use. Given the strong predictive value of suicidal ideation and previous attempts, regular brief screening would appear warranted to identify those at greatest risk.     

Suicidal attempts among patients with substance use disorders who present with suicidal ideation

Background and aimsPatients with addictions have a great risk of suicidal ideation and attempts. Suicidal behaviour is a continuum that begins with ideation and may continue with planning, attempts and suicide completion. Investigating the specific risk characteristics for suicidal attempts in patients with addiction problems who present with suicidal ideation is crucial for developing prevention strategies. The main aims of this study were to determine the prevalence rate of suicide attempts among patients with lifetime suicidal ideation receiving treatment for addiction, and to explore the differential characteristics for suicide ideators with and without suicide attempts.MethodsA sample of 149 patients with suicidal ideation (110 male and 39 female) who sought treatment for addiction in a Spanish clinical centre was assessed.MeasurementsInformation concerning socio-demographic characteristics, addiction severity, and psychopathological symptoms was obtained.ResultsIn total, 39.6% of the patients had attempted suicide (95% Confidence Interval: 32.1%–47.6%). Although all patients with suicidal behaviours presented a high severity in their addiction, patients with both suicidal ideation and suicide attempts showed a more severe addiction profile and more maladjustment to everyday life than patients with only suicidal ideation. Specifically, three psychopathological variables were related to suicide attempts: worse psychiatric state, previous hospitalization for psychological problems, and history of delirium.ConclusionsAccording to the results, a systematic screening of suicidal risk in patients seeking treatment for addiction problems is recommended. Addiction treatment centres should develop treatment strategies to prevent suicidal ideators from attempting suicide, mainly in those cases with a worse lifetime psychiatric condition.     

认知疗法对自杀意念和行为的干预效果

目的探讨认知疗法对自杀意念和自杀未遂者的干预效果。方法对门诊和住院有严重自杀意念158人和20名自杀未遂者进行贝克的识别自动化思维,识别错误认知和真实性检验技术和梅肯鲍姆的技能获得和复述技术进行心理干预。结果动摇自杀意念效果明显,歪曲认知有所改变,SCL-90平均减分率大于25%,心理状况好转。结论认知疗法是早期消除自杀观念,稳定情绪最有效的方法。     

Attempted suicide among heroin users: 12-month outcomes from the Australian Treatment Outcome Study (ATOS)

A cohort of 495 heroin users, recruited for the Australian Treatment Outcome Study (ATOS), were re-interviewed at 12 months regarding suicide attempts over the follow-up period. The proportion who had attempted suicide in the 12 months since baseline was not significantly different from that reported in the 12 months preceding ATOS enrolment (12.2% versus 9.1%), and attempted suicide did not decline significantly in any of the index treatment groups. Among males, there was no significant reduction in attempted suicide (8.7% versus 8.1%). Among females, however, the proportion reporting an attempt declined significantly from 19.7 to 9.8%. Of those who reported suicidal ideation at baseline, 22.8% made an attempt over the follow-up period, as did 19.0% of those who had major depression. Large, and significant, declines in suicidal ideation (23.1% versus 6.9%) and major depression (25.5% versus 10.9%) occurred over the study period. Independent predictors of a suicide attempt over the follow-up period were: social isolation, having made an attempt in the preceding 12 months, suicidal ideation at baseline, a greater number of treatment episodes and higher levels of baseline polydrug use.     

Attempted suicide among entrants to three treatment modalities for heroin dependence in the Australian Treatment Outcome Study (ATOS): prevalence and risk factors

AIMS: To determine the lifetime and recent histories of attempted suicide among entrants to treatment for heroin dependence in three treatment modalities and a non-treatment comparison group; and to ascertain factors associated with a recent history of attempted suicide. DESIGN: Cross-sectional structured interview. SETTING: Sydney, Australia. PARTICIPANTS: Six hundred and fifteen current heroin users: 201 entering methadone/buprenorphine maintenance (MT), 201 entering detoxification (DTX), 133 entering drug free residential rehabilitation (RR) and 80 not in treatment (NT). FINDINGS: A lifetime history of attempted suicide was reported by 34% of subjects, 13% had attempted suicide in the preceding year and 5% had done so in the preceding month. Females were more likely to have lifetime (44% versus 28%) and 12 month (21% versus 9%) suicide attempt histories. The 12 month prevalence of attempted suicide among treatment groups ranged between 11% (MT, NT) and 17% (RR). Factors associated with recent suicide attempts were: being an RR entrant, female gender, younger age, less education, more extensive polydrug use, benzodiazepine use, recent heroin overdose, Major Depression, current suicidal ideation, Borderline Personality Disorder (BPD)and Post-Traumatic Stress Disorder. CONCLUSIONS: Recent suicidal behaviour is a major clinical problem for heroin users, and for females and RR entrants in particular. An essential adjunct to treatment for heroin dependence is routine screening for depression and suicidal ideation, with the provision of appropriate treatment where needed.     

Precontemplated and impulsive suicide attempts among individuals with alcohol dependence

OBJECTIVE: Alcohol dependence confers risk for suicidal behavior. Some suicide attempts are precontemplated, whereas other attempts are impulsive. The purpose of this study was to compare characteristics and correlates of impulsive and precontemplated suicide attempts. METHOD: Data were derived from analysis of The Collaborative Study on the Genetics of Alcoholism (COGA), which is a six-site family pedigree study of individuals in treatment for alcoholism (probands), relatives of probands, and control families. Subjects in the analysis were age 18 years or older with a diagnosis of current alcohol dependence according to the Diagnostic and Statistical Manual, Third Edition, Revised. Individuals reporting a lifetime history of one or more suicide attempts were divided into two strata: suicide attempters with a history of suicidal ideation that persisted for a week or more, conceptualized as attempters showing precontemplation (n=330), and suicide attempters without a history of persistent ideation, conceptualized as impulsive attempters (n=343). These groups were compared with subjects with no history of attempts (nonattempters; n=3115). RESULTS: Precontemplated acts were carried out with greater intent and were more likely to result in medical treatment. Dependence on illicit drugs and history of depression were more likely among attempters showing precontemplation. Impulsive attempts were more likely to be carried out by women and individuals with higher levels of alcohol-related aggression. CONCLUSIONS: Prevention of precontemplated suicide attempts by individuals with alcohol dependence should include a focus on recognition and treatment of depressive syndromes. Alcohol-related aggression was elevated among impulsive suicide attempters. Prevention efforts may include interventions targeting aggression.     

Identification of suicidal ideation and prevention of suicidal behaviour in the elderly

In almost all industrialised countries, men aged 75 years and older have the highest suicide rate among all age groups. Although in younger age groups suicide attempts are often impulsive and communicative acts, suicide attempts in older people (defined as aged 65 years and older) are often long planned and involve high-lethality methods. These characteristics, in addition to the fact that elderly are more fragile and frequently live alone, more often lead to fatal outcome. In later life, in both sexes, the most common diagnosis in those who attempt or complete suicide is major depression. In contrast to other age groups, comorbidity with substance abuse and personality disorders is less frequent. Physical illness plays an important role in the suicidal behaviour of the elderly: most frequently, depression and illness co-occur; less often, the physical illness or the treating medications are causally related to the depressive symptoms. However, only 2 to 4% of terminally ill elderly commit suicide. In addition to physical illness, complicated or traumatic grief, anxiety, unremitting hopelessness after recovery from a depressive episode and history of previous suicide attempts are risk factors for suicide attempts and completed suicide. During a depressive episode, elderly patients with suicidal ideation have higher levels of anxiety and, during treatment, anxiety decreases the probability of remission and recovery. As well as overt suicide attempts, indirect self-destructive behaviours, which often lead to premature death, are common, especially in residents of nursing homes, where more immediate means to commit suicide are restricted. Although we do not have randomised trials of treatment, studies suggest that antidepressant treatment may decrease suicide risk. Prevention and treatment trials are underway to detect the effectiveness of improved treatment of depression by primary care physicians as a means of reducing the prevalence of depressive symptoms, hopelessness and suicidal ideation.     

Affective psychosis following Accutane (isotretinoin) treatment

Isotretinoin (Accutane) ranks in the top 10 of the US Food and Drug Administration's database of drugs associated with reports of depression and suicide attempts. However, this association is still controversial because up to 5.6% of patients with moderate acne may have pre-existing suicidal ideations, improvement of acne often reduces associated depression, and isotretinoin users are reportedly no more likely than those taking antibiotics for acne to have depression or commit suicide. We describe a series of cases of manic psychosis that developed in a 1-year period (2003) in association with isotretinoin treatment and resulted in suicidality and progression to long-standing psychosis. Cases were drawn from 500 soldiers who had been evaluated in a military specialists dermatology clinic for severe acne. Data were summarized from medical records of five severe acne patients treated by isotretinion during their compulsory military service. Data from their draft board examinations and service records, as well as repeated clinical assessments by certified psychiatrists at the Israel Defense Forces (IDF) Mental Health Department clinic, were evaluated. Five young adults developed manic psychosis within a mean of 7.6 months of exposure to isotretinoin. In three cases, this was accompanied by a suicide attempt, and in three cases, psychosis lasted for longer than 6 months. Either a personal history of obsessive-compulsive disorder, neurological insult or family history of a major psychiatric illness were present in all cases. The present case-series is suggestive of an increase in the likelihood of an association between exposure to isotretinion and manic psychosis. Associated risk factors were both family and personal history of psychiatric morbidity. Further studies are needed to establish our findings.