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[自杀意念首次出现后自杀未遂的风险及危险因素:来自大一和大二医学生的研究结果]

[Risk and risk factors of suicide attempt after first onset of suicide ideation: findings from medical students in grades 1 and 2].

作者信息

Yang Linsheng, Zhang Zhihua, Sun Liang, Wu Hongyan, Sun Yehuan

机构信息

Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.

出版信息

Wei Sheng Yan Jiu. 2014 Jan;43(1):47-53.

Abstract

OBJECTIVE

To examine transition probabilities from first onset of suicide ideation to attempt over time among medical students in grades 1 and 2 and risk factors in the transition.

METHODS

A total of 10 297 college students in grades 1 and 2 from three medical schools in Anhui province were invited to complete the questionnaires, which included history of suicidal behaviors, adverse childhood experiences, family history of suicide, sociodemographic characteristics, the Beck Depression Inventory, the Beck Anxiety Inventory, the Barratt Impulsiveness Scale, the Aggressiveness Questionnaire, and the Social Support Rating Scale. Transitions were estimated using life-table analysis. Risk factors were examined using Cox regression models.

RESULTS

Of the 10,297 participants, 16.52% (n = 1701) reported lifetime ideation and 1.47% (n = 151) attempt. Cumulative probabilities was 8.88% for the transition from first onset of suicide ideation to attempt. The riskest probabilites of transition occurred within 1 year after onset of ideation (7.02%). 76.16% (n = 115) first attempts occurred within 1 year after onset of ideation. Cox regression models analysis found that parents' divorce ( OR = 2.32, 95% CI 1.28-4.21), physical abuse (OR = 1.69, 95% CI 1.20-2.37) , suicidal behavior history of first-degree relatives (OR = 2.02, 95% CI 1.25-3.25), impulsity (middle /lowest tertile: OR = 1.88, 95% CI 1.15-3.06, highest/lowest tertile: OR = 2.09, 95% CI 1.30 -3.36), and highest anxiety scores (highest/lowest tertile: OR = 1. 60, 95% CI 1.10-2.33)were significantly related to the transition from first onset of ideation to attempt.

CONCLUSION

Adolescent suicidal ideation signals the recent rsik for suicide attempts. Parents' divorce, physical abuse, the suicidal behavior history of first-degree relatives, impulsity, and severe anxiety score are risk factors for the transition from first onset of suicide ideation to attempt.

摘要

目的

研究一、二年级医学生从首次出现自杀意念到自杀未遂随时间推移的转变概率以及转变过程中的风险因素。

方法

邀请安徽省三所医学院校的10297名一、二年级大学生完成问卷调查,问卷内容包括自杀行为史、童年不良经历、自杀家族史、社会人口学特征、贝克抑郁量表、贝克焦虑量表、巴拉特冲动性量表、攻击性问卷和社会支持评定量表。使用生命表分析估计转变情况。使用Cox回归模型检验风险因素。

结果

在10297名参与者中,16.52%(n = 1701)报告有终生意念,1.47%(n = 151)有自杀未遂行为。从首次出现自杀意念到自杀未遂的累积概率为8.88%。转变的最高概率发生在意念出现后的1年内(7.02%)。76.16%(n = 115)的首次自杀未遂发生在意念出现后的1年内。Cox回归模型分析发现,父母离异(OR = 2.32,95%CI 1.28 - 4.21)、身体虐待(OR = 1.69,95%CI 1.20 - 2.37)、一级亲属的自杀行为史(OR = 2.02,95%CI 1.25 - 3.25)、冲动性(中等/最低三分位数:OR = 1.88,95%CI 1.15 - 3.06,最高/最低三分位数:OR = 2.09,95%CI 1.30 - 3.36)以及最高焦虑得分(最高/最低三分位数:OR = 1.60,95%CI 1.10 - 2.33)与从首次出现意念到自杀未遂的转变显著相关。

结论

青少年自杀意念预示着近期自杀未遂的风险。父母离异、身体虐待、一级亲属自杀行为史、冲动性和严重焦虑得分是从首次出现自杀意念到自杀未遂转变的风险因素。

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