社区中75例精神分裂症自杀死亡者的特征

目的：为社区中精神分裂症病人的自杀预防，提高依据。方法：用意外死亡问卷对全国社区居民中901例自杀死亡者的家属和知情者进行详细调查，并用SCID－P定式检查的结果按DSM－IV标准做出精神科诊断。结果：75例自杀者确诊为精神分裂症，其中女性明显多于男性（52／23例），年龄中位数为45岁，病程中位数为7年，68％（51例）来自乡村，39％（29例）有自杀未遂史，27％（20例）自杀当时伴有抑郁发作，31％（23例）自杀当时精神分裂症处于缓解期。55％（41例）在自杀前一个月内用过抗精神病药物，32％（24例）从未接受赤精神科治疗，仅有53％（40例）住过精神病院，结论：在社区自杀的精神分裂症患者与住过院自杀精神分裂症患者的特征有所不同，预防住过院和未住过院精神分裂症患者的自杀是迫切需要解决的公共卫生问题。

Characteristics of 75 Suicides of Schizophrenic Individuals Identified in the Community

Objective:To investigate suicide of schizophrenics in comm un ity in order to establish a prevention plan for them Method: A structured interview for accidental deaths was conducted with the family member s and close associates of 901 suicide victims identified among community residen ts from around the country The results of the SCID-P examination were used to determine the psychiatric diagnosis based on DSM-IV criteria Result: Among the 75 suicides diagnosed as schizophrenia, a significantly higher number were female (52 cases vs 23 cases); their median age was 45 years; the ir median duration of illness was 7 years; and 68% (51 cases) came from countrys ide Thirty-nine percent (29 cases) had made a prior suicide attempt, 27% (20 c ases) had a depressive episode at the time of suicide, 55% (41 cases) had used a nti-psychotics in the month prior to suicide Twenty-four cases (32%) had never received mental health treatment and only 53% (40 cases) had ever been admitted to a psychiatric hospital Conclusion: Schizophrenic individua ls who commit suicide identified in the community are different from those who h ave previously been admitted to a psychiatric hospital, preventing both types of suicide is an urgent public health problem