深圳市服务业外来务工人员自杀意念影响因素分析

目的 了解广东省深圳市服务业外来务工人员自杀行为的现状及影响因素。方法 2014年6-8月在深圳市采用同伴推动抽样方法招募1 982名服务业外来务工人员，应用一般健康问卷（GHQ-12）、Connor-Davidson 弹性量表（CD-RISC）、广泛性焦虑量表（GAD-7）、流调中心用抑郁量表（CES-D）、领悟社会支持量表（PSSS）进行调查，建立结构方程模型初步探讨心理状况、心理弹性、焦虑抑郁、社会支持与自杀意念之间的关系。结果 有效调查1 979名深圳服务业外来务工人员，平均年龄为（39.9±12.0）岁，以女性、已婚者和初中文化程度者为主，比例分别为65.1%（1 288/1 979）、83.8%（1 658/1 979）和43.3%（856/1 979）；自杀意念、自杀计划及自杀尝试报告率分别为3.1%（62/1 979）、0.4%（8/1 979）和0.3%（6/1 979）；结构方程模型的主要指标（χ²/df=17.828，NFI=0.959，CFI=0.961，IFI=0.961，RMSEA=0.092，AIC=164.793，BCC=164.935，EVCI=0.083）显示方程模拟较好；抑郁对自杀意念直接作用大小为0.16，心理状况、心理弹性、焦虑、社会支持通过抑郁对自杀意念起间接作用；自杀意念的“负向”影响因素排序为抑郁（直接作用大小0.16，构成比46.2%）>焦虑（作用大小0.10，构成比28.9%）>心理状况（作用大小0.084，构成比24.2%）>社会支持（作用大小0.000 5，构成比0.1%）；“正向”影响因素为心理弹性（作用大小-0.002，构成比0.6%）。结论 抑郁和焦虑是深圳服务业外来务工人员自杀意念的重要危险因素之一，早期筛查抑郁和焦虑情绪是预防服务业外来务工人员自杀重要手段之一。

Influencing factors of suicide ideation among migrant service workers in Shenzhen city

Objective To analyze the prevalence and influencing factors of suicide behaviors among migrant service workers in Shenzhen city. Methods Totally 1 982 migrant service workers were recruited with respondent-driven sampling in Shenzhen city of Guangdong province and surveyed with General Health Questionnaire (GHQ-12), Connor-Davidson Resilience Scale (CD-RISC), Generalized Anxiety Disorder-7 (GAD-7), Center for Epidemiologic Studies Depression Scale (CES-D), and Perceived Social Support Scale (PSSS) between June and August 2014.Structural equation model was used to explore relationships between suicidal ideation and influencing factors. Results The average age of the 1 979 migrant service workers with valid information was 39.9±12.0 years and the majority of the workers were female (65.1%), married (83.8%), and with the primary school education (43.3%).The prevalence of suicidal ideation, plan, and attempt among the migrant service workers were 3.1%, 0.4%, and 0.3%, respectively.The constructed structural equation model fit the data well (χ²/df=17.828, normed fit index[NFI]=0.959, comparative-fit index[CFI]=0.961, incremental fit index[IFI]=0.961, root mean square error of approximation[RMSEA]=0.092, Akaike information criterion[AIC]=164.793, Brownne-Cudeck criterion[BCC]=164.935, estimated cross validation index[EVCI]=0.083).Depression showed direct influence on suicidal ideation, while other factors including psychological status, psychological resilience, anxiety, and social support had indirect impacts.According to the percentage of the contribution, the negative influencing factors were ranked as following:depression (46.2%), anxiety (28.9%), psychological status (24.2%), and social support (0.1%).The psychological resilience (0.6%) was a positive influencing factor. Conclusion Depression and anxiety are the most important risk factors of suicidal ideation among migrant service workers in Shenzhen city, suggesting that screening on depression and anxiety may be a major measure for suicide prevention in the population.