Singh Paramjeet, Shah Raghav, Midha Purav, Soni Ajitabh, Bagotia Sunil, Gaur Kusum Lata
Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India.
Indian J Psychiatry. 2016 Jul-Sep;58(3):301-306. doi: 10.4103/0019-5545.192022.
Sociocultural factors complement psychopathological factors that result in deliberate self-harm (DSH). A study of change in these factors over time is essential for preventive action.
To identify factors influencing DSH, which have shown significant variation over a period of 10 years.
Two hospital-based cross-sectional analytic types of observational studies were performed at two different times at an interval of 10 years.
Sociodemographic profile, factors related to DSH, stressful life events, and psychiatric disorders were assessed in two groups of patients drawn from the same tertiary care hospital, 100 consecutive patients in 2002 and 117 in 2012. The observations were compared to identify factors that have undergone significant change.
Descriptive statistics along with Chi-square test was used in this study.
A significant decrease in the overall number of married subjects (60% vs. 43%) and an increase in the number of unmarried females (34% vs. 61%) were seen. A significant increase in the overall number of rural subjects (17% vs. 34%) and especially in a number of rural females (7% vs. 23%) was also seen. An increase in subjects from middle socioeconomic class (15% vs. 29%) and education up to secondary school (9% vs. 25%) was also seen. A significantly higher number of subjects had a psychiatric disorder (50% vs. 81%) with a significant increase in diagnoses of depression (36% vs. 67%). Family and social issues remain the most common antecedent stressful events. Chemical methods are still the most preferred means, but a higher number (8% vs. 18%) report a history of self-harm.
Variations in factors responsible for DSH identified in this comparative study have preventive implications.
社会文化因素与导致蓄意自伤(DSH)的心理病理因素相互补充。对这些因素随时间的变化进行研究对于预防行动至关重要。
确定在10年期间有显著变化的影响DSH的因素。
在两家不同的医院,以10年为间隔,分两次进行了两种基于医院的横断面分析类型的观察性研究。
对来自同一三级护理医院的两组患者进行社会人口学概况、与DSH相关的因素、应激性生活事件和精神障碍的评估,2002年连续选取100例患者,2012年选取117例。对观察结果进行比较,以确定发生显著变化的因素。
本研究采用描述性统计以及卡方检验。
已婚受试者总数显著减少(60%对43%),未婚女性数量增加(34%对61%)。农村受试者总数显著增加(17%对34%),尤其是农村女性数量增加(7%对23%)。社会经济阶层为中等的受试者数量增加(15%对29%),接受中学及以下教育的受试者数量增加(9%对25%)。患有精神障碍的受试者数量显著增多(50%对81%),抑郁症诊断显著增加(36%对67%)。家庭和社会问题仍然是最常见的先行应激事件。化学方法仍是最常用的手段,但报告有自伤史的人数增多(8%对18%)。
在这项比较研究中确定的导致DSH的因素变化具有预防意义。