单相抑郁症患者自杀行为遗传效应及遗传方式的研究

目的探讨单相抑郁症患者自杀行为的遗传效应及方式。方法 采用严格的纳入标准,对115例抑郁症患者应用家族史法进行研究,用医学遗传数学方法中分离分析和多基因阈值理论进行遗传方式的探讨,并与对照组(395名)比较。结果 单相抑郁症患者自杀危险性较其一级亲属高(P<0.01),单相抑郁症患者一级亲属自杀危险性较对照组高(P<0.01),有自杀行为患者的一级亲属较无自杀行为患者的一级亲属自杀危险性高(P<0.05)。单相抑郁症自杀行为的加权平均遗传率及标准误为(70.16±0.79)％;一级亲属自杀行为预期发病率为3.1％,实际发病率为2.6％,两者差异无显著性意义(P>0.05)。结论 单相抑郁症自杀行为有明显的遗传效应,其遗传方式符合多基因遗传。     

伴人格障碍自杀未遂者临床特点研究

目的：探讨伴人格障碍自杀未遂者的临床特点。方法：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，对两组的社会人口学资料和临床资料进行统计，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，伴人格障碍自杀未遂者与不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。结论：对伴人格障碍自杀未遂者应给予特别对待和积极治疗。     

Hiking in Suicidal Patients: Neutral Effects on Markers of Suicidality

Background

Regular physical activity promotes physical and mental health. Psychiatric patients are prone to a sedentary lifestyle, and accumulating evidence has identified physical activity as a supplemental treatment option.

Methods

This prospective, randomized, crossover study evaluated the effects of hiking in high-risk suicidal patients (n = 20) who performed 9 weeks of hiking (2-3 hikes/week, 2-2.5 hours each) and a 9-week control period.

Results

All patients participated in the required 2 hikes per week and thus showed a compliance of 100%. Regular hiking led to significant improvement in maximal exercise capacity (hiking period Δ: +18.82 ± 0.99 watt, P < .001; control period: P = .134) and in aerobic capability at 70% of the individual heart rate reserve (hiking period Δ: +8.47 ± 2.22 watt; P = .010; control period: P = .183). Cytokines, associated previously with suicidality (tumor necrosis factor-α, interleukin-6, S100), remained essentially unchanged.

Conclusions

Hiking is an effective and safe form of exercise training even in high-risk suicidal patients. It leads to a significant improvement in maximal exercise capacity and aerobic capability without concomitant deterioration of markers of suicidality. Offering this popular mode of exercise to these patients might help them to adopt a physically more active lifestyle.     

A Systematic Review of the Effects of Urban Living on Suicidality and Self-Harm in the UK and Ireland

We conducted a systematic review to answer the following: (a) Is there any evidence to support increased prevalence of suicidality and self-harm (i.e. self-harm or suicidality) in urban versus rural environments? (b) What aspects of the urban environment pose risk for suicidality and self-harm? Thirty-five studies met our criteria. Our findings reflect a mixed picture, but with a tendency for urban living to be associated with an increased risk of suicidality and self-harm over rural living, particularly for those living in deprived areas. Further research should focus on the clustering and additive effects of risk and protective factors for suicidality and self-harm in urban environments.     

认知行为干预对老年抑郁障碍自杀态度影响的研究

目的探讨认知行为干预对老年抑郁障碍患者自杀态度的影响。方法选择2010年3月～2011年10月入住我院的60岁以上首次发病的原发性抑郁障碍患者共60例,随机分为对照组和干预组,各30例。对照组采取常规精神科护理干预方法;干预组在此基础上实施个体化的认知行为干预。运用自杀态度问卷(Questionnaire of suicide attitude,QSA)对干预效果进行评定。结果入院第6周末,干预组分值显著高于对照组:对自杀行为性质的认识(t=-13.27,P<0.01)、对自杀者的态度(t=-8.84,P<0.01)、对自杀者家属的态度(t=-6.06,P<0.01)、对安乐死的态度(t=-13.13,P<0.01)4个维度差异有显著意义。结论认知行为综合干预对改善老年抑郁障碍患者的自杀态度有明显的影响。     

自杀可能性量表的信效度研究

目的本研究检验了国外"自杀可能性量表"(Suicide Probability Scale,SPS)中文版适用性。方法通过对原问卷"翻译-回译"过程建立中文翻译版,选取367名大学生被试进行测试,其中100人在2周后进行了重测。通过探索性因素分析、验证性因素分析检验其结构效度,通过与SSI问卷的比较计算相容效度,通过相关分析考察问卷的信度。结果SPS中文版的探索性因素分析(因子载荷绝对值0.433～0.915)和验证性因素分析(RESEA=0.047,NNFI=0.901,CFI=0.915,IFI=0.916),结果都与原问卷相符合,与SSI问卷比较发现SPS具有良好的效度指数(α=0.765);问卷的内部一致性信度在0.701～0.889之间,分半信度在0.693～0.881之间,重测信度在0.623～0.848之间,均达到了心理测量学的要求。结论修订后的中文版SPS具有良好的信效度指标,可以作为评定中国大学生自杀企图的测量工具使用。     

高职生自杀意念及其影响因素研究

目的探讨临床医学类高职生自杀意念的发生率及其与气质性乐观、生活事件、抑郁及绝望的关系,为自杀意念的早期干预提供依据。方法采用随机抽样方法,应用一般情况调查表、自杀意念自评量表(SIOSS)、乐观量表(LOT-R)、青少年生活事件量表(ASLEC)、抑郁自评量表(SDS)和贝克绝望量表(BHS),对安徽省某医学高职院校一～三年级373名学生进行调查,通过单因素和多因素分析,探讨自杀意念与生活事件、气质性乐观之间的关系。结果临床医学高职生自杀意念检出率为16.09%,男生高于女生。Logistic回归分析显示,负性生活事件、抑郁、绝望是自杀意念的主要危险因素,而气质性乐观是自杀意念产生的保护性因素。结论临床医学高职生自杀意念的发生率较高。应针对主要危险因素和保护性因素采取有效措施,力求把高职生自杀意念和自杀行为的发生降到最低。     

Overcoming the fear of lethal injury: Evaluating suicidal behavior in the military through the lens of the Interpersonal–Psychological Theory of Suicide

Suicide rates have been increasing in military personnel since the start of Operation Enduring Freedom and Operation Iraqi Freedom, and it is vital that efforts be made to advance suicide risk assessment techniques and treatment for members of the military who may be experiencing suicidal symptoms. One potential way to advance the understanding of suicide in the military is through the use of the Interpersonal–Psychological Theory of Suicide. This theory proposes that three necessary factors are needed to complete suicide: feelings that one does not belong with other people, feelings that one is a burden on others or society, and an acquired capability to overcome the fear and pain associated with suicide. This review analyzes the various ways that military service may influence suicidal behavior and integrates these findings into an overall framework with relevant practical implications. Findings suggest that although there are many important factors in military suicide, the acquired capability may be the most impacted by military experience because combat exposure and training may cause habituation to fear of painful experiences, including suicide. Future research directions, ways to enhance risk assessment, and treatment implications are also discussed.