Wei Shengnan, Li Haiyan, Hou Jinglin, Chen Wei, Chen Xu, Qin Xiaoxia
Brain Function Research Section, First Affiliated Hospital, China Medical University, 155 Nanjing Road North, Shenyang, 110001 Liaoning People's Republic of China.
Department of Radiology, First Affiliated Hospital, China Medical University, 155 Nanjing Road North, Shenyang, 110001 Liaoning People's Republic of China.
Ann Gen Psychiatry. 2017 Dec 1;16:44. doi: 10.1186/s12991-017-0167-x. eCollection 2017.
Major depressive disorder (MDD) is a known major risk factor for suicide due to the high suicide mortality. However, studies comparing the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in China are very limited. This study examined and compared the sociodemographic and psychological characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in emergency departments of general hospitals to better understand the risk factors for suicide attempts in China.
All subjects were enrolled in the study between June 2007 and January 2008. A total of 127 suicide attempters-54 with MDD and 73 with no psychiatric diagnosis-were enrolled. The sociodemographic and clinical characteristics were compared between two groups using the statistical analysis performed using frequency distribution, Student's test, Chi-square test, and Fisher's exact test and a logistic regression model.
Suicide attempters with MDD were more likely to be more depressive, older, divorced or separated, unemployed, and living alone, and more likely to write a suicide note, have suicide ideation, and be motivated by reducing pain and burden. Suicide attempters with no psychiatric diagnosis were more likely to be younger and more impulsive, have self-rescue, and be motivated by threatening or taking revenge on others. Multivariate logistic regression analysis identified the following independent predictors of suicide attempts in individuals with MDD: a lower score on the quality of life scale, more years of education, and suicide ideation.
The present study found both similarities and differences in the sociodemographic and clinical characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in the emergency departments of general hospitals in China. These findings will help us to recognize the characteristics of suicide attempters in both groups and develop specific interventions for the two types of suicide attempters to prevent future suicide in China. For example, the suicide attempters with MDD in the emergency departments must be advised to the psychological clinic.
由于自杀死亡率高，重度抑郁症（MDD）是已知的自杀主要风险因素。然而，在中国，比较重度抑郁症自杀未遂者与无精神疾病诊断的自杀未遂者特征的研究非常有限。本研究调查并比较了综合医院急诊科中患有MDD的自杀未遂者和无精神疾病诊断的自杀未遂者的社会人口学和心理特征，以更好地了解中国自杀未遂的风险因素。
所有受试者于2007年6月至2008年1月期间纳入研究。共纳入127名自杀未遂者，其中54名患有MDD，73名无精神疾病诊断。使用频率分布、学生t检验、卡方检验、费舍尔精确检验和逻辑回归模型进行统计分析，比较两组之间的社会人口学和临床特征。
患有MDD的自杀未遂者更可能抑郁程度更高、年龄更大、离婚或分居、失业且独居，更可能留下遗书、有自杀念头，且动机是减轻痛苦和负担。无精神疾病诊断的自杀未遂者更可能更年轻、更冲动，进行自救，且动机是威胁他人或报复他人。多因素逻辑回归分析确定了MDD患者自杀未遂的以下独立预测因素：生活质量量表得分较低、受教育年限较长和有自杀念头。
本研究发现，中国综合医院急诊科中患有MDD的自杀未遂者和无精神疾病诊断的自杀未遂者在社会人口学和临床特征方面既有相似之处，也有不同之处。这些发现将有助于我们识别两组自杀未遂者的特征，并针对这两类自杀未遂者制定具体干预措施，以预防中国未来的自杀行为。例如，必须建议急诊科中患有MDD的自杀未遂者前往心理门诊。
