Cheng Y, Tao M, Riley L, Kann L, Ye L, Tian X, Tian B, Hu J, Chen D
National Institute for Health Education, Chinese Center for Disease Control and Prevention, Beijing, China.
Child Care Health Dev. 2009 May;35(3):313-22. doi: 10.1111/j.1365-2214.2009.00955.x.
Suicide has been identified as one of the three leading causes of death in adolescents and young adults. No previous study in China has tested the association between protective factors and urban adolescents' suicidal behaviours. In this study we tested the hypothesis that suicidal behaviours would be associated with multiple protective factors.
A stratified random of 9015 students from 100 junior middle schools in Beijing, Hangzhou, Wuhan and Urumqi completed the Chinese version of Global School-Based Student Health Survey.
Overall, 17.4% of students had seriously considered attempting suicide, and 8.1% had made a specific plan to attempt suicide during the 12 months preceding the survey. The students in Wuhan (18.7%) and Urumqi (20.8%) cities were significantly more likely than students in Beijing (14.4%) and Hangzhou (14.4%) to have suicidal ideation (chi2 = 45.9, P < 0.001). Female students were significantly more likely than male students to have suicidal ideation and have made suicide attempts [odds ratio (OR) = 1.4, P < 0.001]. Results indicated that the rates of suicidal ideation and suicide attempts increased with age (OR = 1.44, P < 0.001). Multivariate logistic regression models showed that suicide risk tended to decrease significantly when 'days of missed classes or school without permission were less than one', and when students thought students in their school were kind and helpful most of the time or always', 'parents or guardians checked to see if homework was done most of the time or always', 'parents or guardians understood their problems and worries most of the time or always' and 'parents or guardians really know what they are doing with their free time most of the time or always'.
Adolescent suicide behaviour should be a serious problem. Measures can be taken to prevent suicide by observing the factors significantly linked to suicidal behaviour. Steps can then be taken to identify adolescents who have serious suicidal ideation so that intervention can be taken to reduce the suicidal rate.
自杀已被确定为青少年和青年的三大主要死因之一。此前中国尚无研究检验保护因素与城市青少年自杀行为之间的关联。在本研究中，我们检验了自杀行为会与多种保护因素相关联这一假设。
从北京、杭州、武汉和乌鲁木齐的100所初中抽取9015名学生进行分层随机抽样，他们完成了中文版的全球基于学校的学生健康调查。
总体而言，17.4%的学生曾认真考虑过自杀未遂，8.1%的学生在调查前12个月内制定过自杀的具体计划。武汉（18.7%）和乌鲁木齐（20.8%）的学生比北京（14.4%）和杭州（14.4%）的学生有自杀意念的可能性显著更高（χ2 = 45.9，P < 0.001）。女生比男生有自杀意念和自杀未遂的可能性显著更高[比值比（OR）= 1.4，P < 0.001]。结果表明，自杀意念和自杀未遂的发生率随年龄增长而增加（OR = 1.44，P < 0.001）。多因素逻辑回归模型显示，当“旷课或未经允许缺课天数少于1天”，以及学生认为“学校里的同学大多数时候或总是友善且乐于助人”、“父母或监护人大多数时候或总是检查作业是否完成”、“父母或监护人大多数时候或总是理解他们的问题和担忧”、“父母或监护人大多数时候或总是真正了解他们在空闲时间做什么”时，自杀风险往往会显著降低。
青少年自杀行为应是一个严重问题。可通过观察与自杀行为显著相关的因素来采取预防自杀的措施。然后可采取措施识别有严重自杀意念的青少年，以便进行干预以降低自杀率。
