Okan Ibiloglu Aslihan, Atli Abdullah, Demir Suleyman, Gunes Mehmet, Kaya Mehmet Cemal, Bulut Mahmut, Sir Aytekin
Department of Psychiatry, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
Neuropsychiatr Dis Treat. 2016 Feb 23;12:407-16. doi: 10.2147/NDT.S97471. eCollection 2016.
Suicide is an important health problem in Turkey as it is in all regions of the world. Suicidal behavior has multiple causes, which are broadly divided into those related to proximal stressors and those due to predisposition. Suicide statistics may be associated with mental health disorders, which are among the foremost predictors of suicide attempts. More than 90% of patients who commit suicide have a diagnosable psychiatric disorder, usually a major depressive disorder. Other major risk factors for suicide attempts are history of suicide attempts in the family, stressful life events, sleep disturbances, poor income, unemployment, severity of symptoms of depression, and anxiety. Sleep is a complex phenomenon. Sleep disturbances can therefore be contributed to the emergence of suicidal behavior allowing for the possibility of predicting future suicides.
We evaluated 106 patients who were admitted after suicide attempts to the Department of Psychiatry at Dicle University Faculty of Medicine. The recruited subjects were assessed by Structured Clinical Interview for DSM-IV Axis I disorders, and the intensity of symptoms was evaluated using the Beck Anxiety Inventory, Hamilton Depression Rating Scale, and Pittsburgh Sleep Quality Index. The mean values of the subjects attempting multiple and single suicides were compared using appropriate inferential statistical tests.
Most suicide attempts are believed to be preventable. Our results revealed that a great variety of risk factors are associated with an increased risk for multiple suicide attempts. Most of these attempts appeared to be spontaneous and impulsive rather than planned. In particular, this study highlights the importance of previous suicide attempts, history of suicide in the family, history of stressful life events in the previous 6 months, poor income, unemployment, sleep disturbances, severe hopelessness with depression, and coexisting symptoms of anxiety as risk factors.
The first step in prevention of suicides is doubtlessly strong and reliable communication, due to the fact that the majority of subjects who commit suicide have had contact with a health professional during the month before the suicide.
与世界上所有地区一样，自杀在土耳其是一个重要的健康问题。自杀行为有多种原因，大致可分为与近期应激源相关的原因和由易感性导致的原因。自杀统计数据可能与精神健康障碍有关，而精神健康障碍是自杀未遂的首要预测因素之一。超过90%的自杀患者患有可诊断的精神疾病，通常是重度抑郁症。自杀未遂的其他主要风险因素包括家族自杀未遂史、生活压力事件、睡眠障碍、低收入、失业、抑郁症状的严重程度以及焦虑。睡眠是一种复杂的现象。因此，睡眠障碍可能导致自杀行为的出现，从而有可能预测未来的自杀行为。
我们评估了106名自杀未遂后入住迪克莱大学医学院精神病科的患者。通过《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈对招募的受试者进行评估，并使用贝克焦虑量表、汉密尔顿抑郁评定量表和匹兹堡睡眠质量指数评估症状的严重程度。使用适当的推断性统计检验比较多次自杀未遂和单次自杀未遂受试者的平均值。
大多数自杀未遂被认为是可以预防的。我们的结果表明，多种风险因素与多次自杀未遂风险的增加有关。这些未遂行为大多似乎是自发和冲动的，而非有计划的。特别是，本研究强调了既往自杀未遂史、家族自杀史、过去6个月内的生活压力事件史、低收入、失业、睡眠障碍、严重的抑郁绝望感以及并存的焦虑症状作为风险因素的重要性。
毫无疑问，预防自杀的第一步是强有力且可靠的沟通，因为大多数自杀者在自杀前一个月内曾与医疗专业人员接触过。
