【摘要】 目的 比较有、无精神障碍诊断的自杀未遂者的特征。方法 由精神科主治医生对综合医院急诊室收治的617例自杀未遂者及其家属进行调查,采用多因素logistic回归模型比较237例有精神障碍和380例无精神障碍诊断的自杀未遂者的特征。结果 有精神障碍诊断的自杀未遂者生命质量相对较低(调整OR:7.40,95%CI:4.58~11.97),自杀意图强(调整OR:2.96,,95%CI:1.85~4.72),有自杀未遂史者更为常见(调整OR:2.71,95%CI:1.40~5.24),负性生活事件导致的慢性心理压力大(调整OR:2.03,95%CI:1.25~3.29);而无精神障碍诊断的自杀未遂者则较常采用口服农药的方式(调整OR:0.49,95%CI:0.28~0.84),自杀当时的急性应激强度高(调整OR:0.61,95%CI:0.38~0.99)。结论 有、无精神障碍诊断的自杀未遂者的特征存在本质差异,有效预防两类自杀行为的发生应有针对性地采取不同的措施。更多还原

【Abstract】 Objective To compare the characteristics of attempted suicides with or without a mental disorder in China. MethodsAttending-level psychiatrists administered a 2-3 hour survey to 617 medically serious suicide attempters and their accompanying family members identified in emergency rooms of twelve general hospitals in Central and South-western China. Measures employed in this study included an adapted version of the Structured Clinical Interview for DSM-IV, the Family Adaptability and Cohesion Scale(FACES II-CV), a 6-item scale for quality-of-life, a 60-item scale for life events, and the Suicidal Intent Scale. Data for sociodemographic characteristics, the circumstances of current attempt and suicide-related factors were also collected. Multivariate logistic regression models were used to compare the characteristics of 237(38%) attempted suicides with a current mental disorder to those of 380(62%) without a mental disorder. Results More than seventy percent of the attempters were female, under 45 years of age, and lived in rural areas. The multivariate logistic regression model showed that attempters with a mental disorder were more likely to have a lower quality of life score in last month(Adjusted OR:7.40, 95%CI:4.58~11.97), higher suicide intent(Adjusted OR:2.96, 95%CI:1.85~4.72), previous suicide attempts(Adjusted OR:2.71, 95%CI:1.40~5.24), and a higher chronic stress score from negative life events(Adjusted OR:2.03, 95%CI:1.25~3.29). However, attempters without a mental disorder were more likely to have ingested pesticides(Adjusted OR:0.49, 95%CI:0.28~0.84) and have a higher acute stress score from negative life events at time of attempt(Adjusted OR:0.61, 95%CI:0.38~0.99). Conclusions Suicide attempters in China with a mental disorder are fundamentally different from those without a mental disorder. Targeted prevention strategies for these two groups of attempted suicides should be different.更多还原