农村地区有、无精神障碍自杀未遂者及其自杀特征的比较

目的　比较农村地区有、无精神障碍自杀未遂者的特征。方法　以 1998年 8月至 2 0 0 0年 8月四所县 (市 )级综合医院急诊室中自杀未遂者 (共 5 78例 )为研究对象 ,有 32 6例完成自制问卷调查 ;其中 12 9例 ( 39 6 % )符合美国精神障碍诊断与统计手册第 4版中精神障碍的诊断标准 (有精神障碍组 ) ,197例 ( 6 0 4 % )无精神障碍 ,比较两组的特征。结果　 ( 1)两组社会人口学各变量的差异均无显著性 (P >0 0 5 ) ;有精神障碍组既往有自杀未遂史的比例 ( 2 7 9% )高于无精神障碍组 ( 8 2 % ) ,而口服农药 ( 75 2 % )和冲动性自杀的比例 ( 2 7 3% )低于无精神障碍组 (分别为 88 3%和 6 9 4 % ) ;( 2 )有精神障碍组的自杀意图强、慢性负性生活事件 (对心理影响≥ 1年 )多 ,急性应激强度小 (均P <0 0 0 1)。结论　有、无精神障碍自杀未遂者及自杀特征明显不同 ,对两种自杀人群应采取不同的干预措施。

Comparison of attempted suicides in rural residents with or without mental disorder

Objective To compare the characteristics of rural residents who had attempted suicide with or without a mental disorder Methods Subjects were 578 emergent patients having committed suicide in four general hospitals in rural areas from August 1998 to August 2000 The subjects and their family members were interviewed with an extensive interview schedule Patients were classified as having a mental illness or not according to DSM IV diagnostic criteria, and the characteristics of two groups were compared Results Among the 578 patients, 326 completed all the questionnaires Compared to those without a mental disorder, the patients with mental disorder were more likely to have made a prior suicide attempt (27 9% vs 8 2%), were less likely to have made an impulsive attempt (27 3% vs 69 4%), had a stronger intent to die, had more chronic life events (in which the psychological effect lasted for more than one year), and had less acute stress at the time of the attempt (all P< 0 001) Conclusion There are marked differences of the characteristics of attempted suicides in those with and without a mental disorder, which suggest to take different approaches to prevention