Zonda Tamás
Department of Psychiatry, Jahn Hospital, Budapest, Hungary.
Crisis. 2006;27(3):125-9. doi: 10.1027/0227-5910.27.3.125.
The authors performed a case-controlled psychological autopsy study of 100 successive suicides in Budapest, examining the presence of major depression, alcohol, and drug and/or medicament dependency/ abuse according to DSM-IV. The presence of somatic diseases, psychosocial stress, oppressive experiences, and interpersonal relationship disorders within the period of 1 month previous to death was also examined. The control group of 100 people who died of natural causes was identical with the suicide group in respect of number, sex, and age.
Among those committing suicide, psychosocial stress, oppressive experiences, and interpersonal relationship disorders were much more frequent and behavioral changes occurred more often in the weeks preceding death compared to the control group. A single suicide attempt during one's life span did not prove to be predictive for a later fatal action, but multiple attempts did. Major depression was diagnosed in 36% of the cases in the suicide group and 17% in the control group. Half of major-depressed suicides (18 persons) and almost all in the control group (16 persons) suffered from reactive (secondary) major depression as a result of somatic disease. Severe alcoholism was found in 33% of the suicide cases and in 44% of the control group. Drug and/or medicament consumption (misuse and/or abuse) occurred in 14% and 8% of the cases, respectively. The data emphasize again that alcoholism seems to be one of the most serious problems in Hungary both in psychological and somatic illnesses.
作者对布达佩斯连续100例自杀案例进行了病例对照心理解剖研究,根据《精神疾病诊断与统计手册》第四版(DSM-IV)检查重度抑郁症、酒精以及药物和/或药物依赖/滥用情况。还检查了死亡前1个月内躯体疾病、心理社会压力、压迫性经历和人际关系障碍的存在情况。100名自然死亡者组成的对照组在人数、性别和年龄方面与自杀组相同。
与对照组相比,自杀者中心理社会压力、压迫性经历和人际关系障碍更为常见,且在死亡前几周行为变化更频繁。一生中单次自杀未遂并不能预测后来的致命行为,但多次自杀未遂则可以。自杀组中36%的病例被诊断为重度抑郁症,对照组为17%。重度抑郁自杀者中有一半(18人)以及对照组几乎所有病例(16人)因躯体疾病患有反应性(继发性)重度抑郁症。33%的自杀案例和44%的对照组存在严重酒精中毒。药物和/或药物消费(滥用和/或误用)分别出现在14%和8%的案例中。数据再次强调,酗酒在匈牙利似乎是心理和躯体疾病中最严重的问题之一。