有无精神障碍自杀未遂者的临床特征和心理社会因素比较

目的 比较有无精神障碍自杀未遂者的自杀行为学特征和心理社会学因素间的差异.方法 以在5家医院急诊室诊治的232例自杀未遂者为研究对象,分为有精神障碍组(105例)和无精神障碍组(127例),比较两组间的自杀行为学特征和健康状况、生活质量、焦虑、抑郁、应付方式和行为的冲动攻击性等.结果 有精神障碍组平均年龄大于无精神障碍组[(37.9±l4.5)岁,(32.9±13.3)岁,t=2.710,P=0.007]；女性所占比例较低(65.7％,81.1％,x2=7.099,P=0.008)；自杀意向强度较高[(7.1±2.8)分,(4.8±2.3)分,t=6.498,P=0.000].有精神障碍组健康状况、抑郁、焦虑评分高于无精神障碍组,健康量表、冲动性及各因子的评分高于无精神障碍组,解决问题和求助的应付方式因子评分低于无精神障碍组,自责的应付方式因子评分高于无精神障碍组(均P＜0.05).结论 有、无精神障碍自杀未遂者具有不同的自杀行为学特征和心理社会学特征,精神疾病在自杀行为的发生中所起的作用更大,自杀强度更强.

Comparison of the clinical and social-psychological characteristics of suicide attempters with and without mental disorder

Objective To compare the clinical and social-psychological characteristics of patients with and without mental disorder.Methods Base the diagnosis of mental disorder,232 suicide attempters were divided into two groups:suicide attempter with mental disorder ( 105 cases) and suicide attempter without mental disorder (127 cases).The Structured Clinical Interview for DSM-Ⅳ,the Strength of Suicide Ideation,Health Questionnaire of WHO,Questionnaire of Life Measure (QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale (BAS),Social Support Rate Scale and Questionnaire of Coping Style (QCS) were conducted.Results The 105 suicide attempters with a mental disorder were older than the 127 suicide attempter without a mental disorder ( 37.9 ± 14.5 vs 32.9 ± 13.3,t =2.710,P =0.007 ),and the percentage of female was lower in the former than in the later(65.7％ vs 81.1％,x2 =7.099,P =0.008 ).In the total of 232 cases,female was more than male with the gender ratio of 2.87 ( female vs male).The strength level of suicide ideation was higher ( 7.1 ± 2.8 vs 4.8 ± 2.3,t =6.498,P =0.000).The scores of health questionnaire of WHO,BDI and BAI were higher in the suicide attempters with a mental disorder than those without a mental disorder,otherwise the scores of QLM,BIS and its three sub-scales were higher.Among QCS,the sub-score of Self-blaming was higher,and the sub-scores of Question solvation and Asking for help were lower.Conclusion There are distinguished differences on the sociodemographic and psychological characteristics among the suicide attempters with and without a mental disorder.Mental diseases play an important role in the development of suicide attempter with a mental disorder.