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与自杀未遂相关的危险因素特征:来自印度奥里萨邦的一项研究。

Profile of risk factors associated with suicide attempts: A study from Orissa, India.

机构信息

Mental Health Directorate, Wolverhampton City Primary Care Trust, Corner House Resource Centre, 300, Dunstall Road, Wolverhampton, WV6 0NZ, UK.

出版信息

Indian J Psychiatry. 2010 Jan;52(1):48-56. doi: 10.4103/0019-5545.58895.

Abstract

CONTEXT

Periodic systematic profiling of suicidal risk factors in developing countries is an established need.

AIMS

It was intended to study the risk factors associated with suicide attempts in Orissa, one of the most economically compromised states of India.

SETTINGS AND DESIGN

Cross-sectional study in a general hospital.

MATERIALS AND METHODS

Consecutive 149 suicide attempters were evaluated for psychosocial, situational, and clinical risk factors using the Risk Rescue Rating scale, Suicide Prevention Center scale, Lethality of Suicide Rating scale, and Presumptive Stressful Life Event scale. They were compared with healthy and psychiatric controls who had never attempted suicide.

STATISTICAL ANALYSIS

Chi-square for comparison of categorical variables, t-tests for comparison of means.

RESULTS

The male-to-female ratio was closer to one in adults and around 1:3 in adolescents. Younger age, lower-middle economic group, rural background, unemployed, school educated were more represented in this study. Compared to the controls, significantly more number of attempters had a family history of psychiatric illness and suicide, childhood trauma, medical consultation within one month, had experienced stressful life events and had expressed suicidal ideas. In a considerable proportion of attempts, risk was high and rescuability least; 59.1% had more than 50% chance of death. Suicide potential was high in almost half the cases. More than 80% of all attempters had psychiatric disorder; however, only 31.5% had had treatment. Factors like middle age, family history of psychiatric disorders, past psychiatric history, current psychiatric illness, communication of suicidal ideas, the use of physical methods, and high potential attempts, differentiated repeaters significantly from the first-timers. Major physical illness, family and marital conflicts, financial problems, and failure in examinations were more frequent life events. Childhood trauma, noted in around 40% of the attempters, was considerably associated with adolescent suicide attempts.

CONCLUSIONS

Modifiable risk factors identified in this study have preventive implications.

摘要

背景

定期系统地对发展中国家的自杀风险因素进行评估是一项既定需求。

目的

旨在研究印度经济最脆弱的邦之一——奥里萨邦自杀未遂的相关风险因素。

设置和设计

在一家综合医院进行的横断面研究。

材料和方法

使用风险救援评分量表、自杀预防中心量表、自杀致死性评分量表和推定应激性生活事件量表,对 149 名连续自杀未遂者进行社会心理、情境和临床风险因素评估。将他们与从未尝试过自杀的健康和精神科对照组进行比较。

统计分析

卡方检验用于比较分类变量,t 检验用于比较均值。

结果

成年组的男女比例接近 1:1,而青少年组则接近 1:3。在本研究中,年龄较小、中下经济阶层、农村背景、失业、接受过学校教育的人群比例更高。与对照组相比,更多的尝试者有精神疾病和自杀家族史、儿童创伤、一个月内就诊、经历过应激性生活事件和表达过自杀想法。在相当一部分尝试中,风险很高,可挽救性最低;59.1%的人死亡概率超过 50%。近一半的自杀企图者自杀风险很高。超过 80%的尝试者有精神障碍;然而,只有 31.5%接受过治疗。中年、精神障碍家族史、既往精神病史、当前精神疾病、表达自杀想法、使用身体方法和高自杀潜在尝试等因素,使重复者与首次尝试者有显著区别。主要的身体疾病、家庭和婚姻冲突、财务问题以及考试失败等生活事件更为常见。大约 40%的尝试者都有儿童创伤经历,这与青少年自杀未遂有很大关联。

结论

本研究确定的可改变风险因素具有预防意义。

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