【摘要】 目的:了解无严重躯体疾病的55岁以上自杀死亡者的特征并比较其中有、无精神障碍者的特征。方法:由精神科医师运用心理解剖方法对全国有地理代表性的23个疾病监测点上报的≥55岁的304例自杀案例的家属和周围知情人进行深入调查。结果:①自杀前一年有严重的急性或慢性躯体疾病者126例(其中女性占42.1%),平均年龄68±9岁;居住在乡村者101例(80.2%),接受正规教育年限的中位数为0年(25%-75%位数:0-3),65.9%从未上过学;33.3%丧偶;23.0%有自杀未遂既往史,16.1%一级血缘亲属有自杀行为;64.3%服农药或鼠药自杀,6.3%自杀当时有人在场并知道自杀的发生。②126例中有、无精神障碍者分别为76例(60.3%)和50例(39.7%)。两组相比,有精神障碍者年纪轻,现婚比例高,自杀前一个月与人谈论死亡问题的比例高,经历的负性生活事件数目多,慢性心理压力大,自杀前一个月的生命质量低,自杀前2周的抑郁程度重,曾因心理问题寻求帮助的比例高(均P<0.05)。结论:无严重躯体疾病的老年自杀者的特征与其是否患有精神障碍有关。更多还原

【Abstract】 Objective:Describe the characteristics of elderly suicides who did not have serious medical illnesses at the time of death and compare those with and without a mental illness.Method:Psychiatrists conducted psychological autopsy interviews with family members and associates of 304 suicides > 55 years old from 23 geographically representative disease surveillance points from around China.Result: ①Among the 304 suicides 126(41.4%) did not have a serious medical illness in the year prior to death. Among these 126 suicides the mean(sd) age was 68(9) years;42.1% were women; 80.2% were from rural area;the median years of education was 0(25%-75% range=0-3 years);65.9% never attended school;33.3% were widowed;23.0% had made a prior suicide attempt;6.3% had a family history of suicidal behavior in first-degree relatives;64.3% ingested pesticides or rodenticides;in 6.3% of the cases there was someone else present at the time of the suicidal behavior.② Compared to 50(39.7%)suicidees without a mental illness,76 with a diagnosable mental illness were younger;a higher proportion were currently married;more discussed death with others prior to the suicide;and they had experienced more negative life events,higher chronic stress,lower quality of life in the month before the suicide,higher levels of depressive symptoms in the two weeks prior to death,and were more likely to have previously sought help for psychological problems(Ps all <0.05).Conclusion: The characteristics of elder suicides in China without a physical illness are different between those with and without a mental illness at the time of suicide.更多还原