Department of Psychiatry, First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, PR China.
Gen Hosp Psychiatry. 2010 Sep-Oct;32(5):549-55. doi: 10.1016/j.genhosppsych.2010.06.003. Epub 2010 Jul 22.
Compare the sociodemographic and psychological characteristics of suicide attempters admitted to emergency departments of general hospitals in China that do and do not meet diagnostic criteria for mental disorders.
The Structured Clinical Interview for DSM-IV, the Suicide Ideation Scale, the Hamilton Depression Rating Scale and a quality of life measure were administered to 239 consecutive suicide attempters who were treated in the emergency departments of four randomly selected general hospitals in Shenyang.
Among the enrolled subjects, 166 (69.5%) met diagnostic criteria for a current mental disorder. Among these 166 subjects, 62.7% had mood disorders, 14.5% had anxiety disorders, 10.8% had psychotic disorders and 3.6% had substance use disorders. The 73 suicide attempters without a mental disorder were younger, had higher levels of impulsiveness and were more likely to have ideas about being rescued. Multivariate logistic regression analysis identified the following independent predictors of having a current psychiatric disorder in the suicide attempters: female gender (OR=3.67, 95% CI=1.23-10.91), more than 6 years of formal education (OR=1.19, 95% CI=1.04-1.36), a higher score on the suicide ideation scale (OR=1.01, 95% CI=1.00-1.03), a higher score on Hamilton depression rating scale (OR=1.26, 95% CI=1.16-1.37) and a lower score on the quality of life scale (OR=0.75, 95% CI=0.63-0.90).
The prevalence of psychiatric disorders in suicide attempters in emergency departments of urban China is lower than that reported in most western countries. Suicide attempters with and without mental illnesses are distinct on a number of important dimensions. Mental health assessment and appropriate discharge planning for patients treated in emergency departments for suicide attempts are crucial components of comprehensive suicide prevention efforts.
比较中国综合医院急诊科符合和不符合精神障碍诊断标准的自杀未遂者的社会人口学和心理特征。
对在中国沈阳 4 家随机选定的综合医院急诊科接受治疗的 239 例连续自杀未遂者进行 DSM-IV 定式临床访谈、自杀意念量表、汉密尔顿抑郁评定量表和生活质量量表评定。
纳入研究的受试者中，166 例（69.5%）符合当前精神障碍的诊断标准。这些受试者中，62.7%有心境障碍，14.5%有焦虑障碍，10.8%有精神病性障碍，3.6%有物质使用障碍。73 例无精神障碍的自杀未遂者更年轻，冲动性更高，更有可能有获救的想法。多变量逻辑回归分析确定了自杀未遂者目前有精神障碍的以下独立预测因素：女性（OR=3.67，95%CI=1.23-10.91）、受教育年限多于 6 年（OR=1.19，95%CI=1.04-1.36）、自杀意念量表评分较高（OR=1.01，95%CI=1.00-1.03）、汉密尔顿抑郁评定量表评分较高（OR=1.26，95%CI=1.16-1.37）和生活质量量表评分较低（OR=0.75，95%CI=0.63-0.90）。
中国城市急诊科自杀未遂者的精神障碍患病率低于大多数西方国家报告的患病率。有和没有精神疾病的自杀未遂者在许多重要方面存在显著差异。对在急诊科接受自杀未遂治疗的患者进行心理健康评估和适当的出院计划是全面预防自杀工作的重要组成部分。
