Fennig Silvana, Horesh Netta, Aloni Daphna, Apter Alan, Weizman Abraham, Fennig Shmuel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur Child Adolesc Psychiatry. 2005 Dec;14(8):454-60. doi: 10.1007/s00787-005-0498-z.
Suicide is the leading cause of premature death in patients with schizophrenia. Studies have shown a weaker association between suicidal behavior and stressful life events in schizophrenic than in nonschizophrenic subjects. The aim of the present study was to further investigate the complicated relationship of suicide attempts and life events in adolescent schizophrenic patients.
Forty adolescents with a diagnosis of schizophrenia, including 20 who had attempted suicide and 20 who had not, were compared with 20 age-matched subjects with no psychiatric history. The instruments used for the assessment were the Life Events Checklist, the Suicidal Risk Scale, the Sexual Abuse in Childhood Questionnaire, and the Beck Depression Inventory.
Control subjects reported fewer life events in general, and fewer negative events, events of sexual abuse, and events associated with impaired family functioning than the schizophrenic patients. Within the schizophrenic group, the suicidal patients reported fewer life events than the nonsuicidal patients, but there was no difference between the groups in the number of negative or sexual-abuse events. However, the proportion of negative life events out of total life events was higher in the suicidal group, and their perceived impact was stronger. Levels of depression and suicidality were higher in the suicidal schizophrenic patients than in the nonsuicidal patients.
In adolescent patients with schizophrenia, suicidal behavior is associated less with the number of life events and more with their perception of the events as negative and the impact of these events on the individual.
自杀是精神分裂症患者过早死亡的主要原因。研究表明，与非精神分裂症患者相比，精神分裂症患者的自杀行为与应激性生活事件之间的关联较弱。本研究的目的是进一步探究青少年精神分裂症患者自杀未遂与生活事件之间的复杂关系。
将40名诊断为精神分裂症的青少年（包括20名有自杀未遂史的患者和20名无自杀未遂史的患者）与20名年龄匹配且无精神病史的受试者进行比较。评估所使用的工具包括生活事件清单、自杀风险量表、童年期性虐待问卷和贝克抑郁量表。
总体而言，对照组受试者报告的生活事件较少，负面事件、性虐待事件以及与家庭功能受损相关的事件也比精神分裂症患者少。在精神分裂症组中，有自杀行为的患者报告的生活事件比无自杀行为的患者少，但两组在负面或性虐待事件的数量上没有差异。然而，自杀组中负面生活事件占总生活事件的比例更高，且他们感知到的影响更强。有自杀行为的精神分裂症患者的抑郁和自杀倾向水平高于无自杀行为的患者。
在青少年精神分裂症患者中，自杀行为与生活事件的数量关联较小，而与其将事件视为负面以及这些事件对个体的影响关联更大。
