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。

Survey of Suicidal Ideation and Suicide Attempts in Inpatients at 40 General Hospitals in Beijing

Objective: Describe the prevalence and risk factors for suicidal ideation and suicide attempt among inpatients at general hospitals in Beijing.Methods:Data bout suicidal thoughts, suicide attempts and related factors were obtained from 2914 persons 15 years of age or older who were inpatients at 40 randomly selected level-1, level-2 and level-3 general hospitals in Beijing. A multiple logistic regression model was used to identify risk factors for suicidal ideation and suicide attempt.Results:167 (6.4%) of the 2914 inpatients reported prior suicidal ideation; identified risk factors for suicidal ideation were ranked as follows: high frequency of feeling hopeless in last year (OR=9.2, 95% CI 6.5~12.9) prior suicidal behavior in a relative(4.3,2.3~8.3), depressive episode at the time of the interview(2.7,1.7~4.3), non-relative associates with prior suicidal behavior(2.0,1.3~2.9), under 55 years of age(1.7,1.2~2.3), and female gender(1.5,1.1~2.1). 25 (0.9%) of the 2 914 inpatients had made a prior suicide attempt; risk factors for suicide attempt were ranked as follows: depressive episode at the time of interview(OR=5.6, 95% CI 2.1~15.1), prior suicidal behavior in a relative(5.1,1.4~18.9), high frequency of feeling hopeless in prior year(4.7,1.9~11.9), under 55 years of age(3.6,1.4~9.3)and female gender(3.6,1.4~9.3).Conclusion:Inpatients in general hospitals who have depression are a high risk group for suicide; they deserve greater attention. Suicide prevention plans for inpatients of general hospitals focused on the risk factors identified for suicidal ideation and suicide attempt need to be developed, implemented and assessed.