综合医院有自杀倾向的住院患者发生自杀行为的影响因素分析

目的描述综合医院具有自杀倾向患者的特征,并分析此类患者发生自杀行为的危险因素.方法回顾性连续纳入南方医科大学南方医院2012年10月至2017年10月的住院患者中具有自杀倾向的病例共680例,根据是否发生自杀行为分为自杀倾向组(有自杀倾向无自杀行为,527例)和自杀行为组(有自杀倾向亦有自杀行为,153例).收集他们的性别、年龄、婚姻状况、户籍、入院科室、自杀诱因、自杀方式、精神疾患、躯体疾患及显著的精神症状等资料.采用单因素分析比较两组间的社会人口学和临床特征差异,采用二分类Logistic回归分析研究自杀行为的危险因素.结果自杀倾向组主要为女性66.6%(351例)]、已婚77.4%(458例)]、心理科74.4%(392例)]、抑郁症66.2%(349例)].自杀行为组中,男性和女性的自杀方式差异有统计学意义(χ^2=12.489,P=0.014),选择跳楼方式的男性较多,药物及割脉方式的女性更多.Logistic回归分析结果表明,入住重症医学科(OR=7.844,95%CI:2.240~27.475,P=0.001)、婚恋受挫(OR=3.646,95%CI:1.217~10.917,P=0.021),肿瘤(OR=4.620,95%CI:1.552~13.755,P=0.006),双相情感障碍(OR=3.734,95%CI:1.157~12.052,P=0.028)是自杀行为的危险因素.结论具有自杀倾向的患者中,入住重症医学科、双相情感障碍、肿瘤、婚恋挫折是发生自杀行为的危险因素,而且两性的自杀方式有所不同,需要临床高度重视,并采取针对性预防措施.

An investigationofrelated risk factors of suicidal behavior in hospitalized patients with suicidal tendency in general hospitals

Objective To describe the characteristics of patients with suicidal tendency in general hospitals,and to analyze the risk factors of suicidal behaviors in these patients.Methods A total of 680 cases with suicidal tendency were collected from inpatients in NanfangHopsital Affiliated to Southern Medical University from October 2012 to October 2017.According to the occurrence of suicidal behavior,the sample was divided into suicidal tendency group(without suicidal behavior,n=527)and suicidal behavior group(with suicidal behavior,n=153).Data were collected on their gender,age,marital status,household registration,admission department,suicide inducement,suicide pattern,mental illness,physical illness and significant mental symptoms.Univariate analysis was used to compare the socio-demographic and clinical characteristics of the two groups.Binary logistic regression analysis was used to explore the risk factors of suicide behavior.Results The samples in suicidal tendencygroup were mainly female(351,66.6%),married(458,77.4%),psychiatric inpatients(392,74.4%),and suffering from depression(349,66.2%).In the suicide behavior group,there was a significant difference in suicide pattern between men and women(χ^2=12.489,P=0.014).Men were more than women choosing the way of jumping off the building.On the other hand,women were more among those using drugs and wrist-cutting.Logistic regression analysis showed that intensive care unit(ICU)inpatient(OR=7.844,95%CI:2.240-27.475,P=0.001),frustration in marriage(OR=3.646,95%CI:1.217-10.917,P=0.021),tumor(OR=4.620,95%CI:1.552-13.755,P=0.006),bipolar disorder(OR=3.734,95%CI:1.157-12.052,P=0.028)were risk factors of suicide.Conclusions Among the patients with suicidal tendency,ICU inpatient,bipolar disorder,tumor,marriage and love setback are the risk factors of suicidal behavior.Men and women tend to choose different suicide pattern.It requires more attention in clinical practice,and targeted preventive measures.