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[突尼斯革命后儿童和青少年自杀未遂的流行病学及临床概况]

[Epidemiological and clinical profile of suicide attempts in Tunisian children and adolescents after the revolution].

作者信息

Charfi Fatma, Harbaoui Azza, Skhiri Afef, Abbès Zeineb, Belhadj Ahlem, Halayem Soumaya, Bouden Asma

机构信息

Service de Pédopsychiatrie, Hôpital Mongi Slim de La Marsa, Sidi Daoud 2046, Tunis, Tunisie.

Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisie.

出版信息

Pan Afr Med J. 2019 Apr 26;32:204. doi: 10.11604/pamj.2019.32.204.15477. eCollection 2019.

Abstract

BACKGROUND

Suicidal behaviors are increasing in Tunisia at younger and younger ages. This study aims to describe the sociodemographic and clinical profile of suicide attempts in children and adolescents.

METHODS

We conducted a cross-sectional and descriptive study, including 50 suicidal individuals, recruited in the Child Psychiatry Department at the Razi Hospital in Manouba and in two Departments in Tunisia (Intensive Care and Reanimation Department and Department of Pediatrics) between July 2012 and June 2013. We identified the socio-demographic and clinical factors, the histories of abuse, subjects' education, the characteristics of the attempted suicides (TS), suicidal ideation assessed by the Suicidal Intent Scale and psychopathological disorders diagnosed using the Mini-International Neuropsychiatric Interview.

RESULTS

The sex-ratio was 0.56, the average age was 12.4 years ranging from 7 to 16 years. School failure or dropout were found in 86% of suicidal individuals. In 38% of cases suicidal behavior was recurrent; the subjects had a history of self-mutilation to the same extent. A context of abuse was reported in 46% of cases. Drug ingestion was the most common means of suicide, psychotropic drugs were the most common substances used. There was a significant gender difference in the use of the means of suicide: the boys mainly used physical means (P=0.04) while the girls poisoning (P=0.001). Suicidal intent was high in 44% of cases. A major depressive episode and adjustment disorder were the most common disorders found (58% and 24% of cases respectively).

CONCLUSION

Depressive disorders and abuse are risk factors of TS in children and adolescents, these factors should be considered when implementing suicide prevention strategies for this population.

摘要

背景

突尼斯的自杀行为正呈低龄化趋势。本研究旨在描述儿童及青少年自杀未遂者的社会人口学特征和临床特征。

方法

我们开展了一项横断面描述性研究,纳入了50名有自杀行为者,于2012年7月至2013年6月在马努巴的拉齐医院儿童精神科以及突尼斯的两个科室(重症监护与复苏科和儿科)招募。我们确定了社会人口学和临床因素、虐待史、受试者教育情况、自杀未遂(TS)特征、用自杀意图量表评估的自杀意念以及用迷你国际神经精神访谈诊断的精神病理障碍。

结果

性别比为0.56,平均年龄为12.4岁,年龄范围在7至16岁之间。86%的自杀者存在学业失败或辍学情况。38%的案例中自杀行为呈复发性;受试者有同等程度的自残史。46%的案例报告有虐待背景。药物摄入是最常见的自杀方式,精神药物是最常用的物质。在自杀方式的使用上存在显著性别差异:男孩主要使用身体方式(P=0.04),而女孩则是中毒(P=0.001)。44%的案例自杀意图强烈。最常见的障碍是重度抑郁发作和适应障碍(分别占案例的58%和24%)。

结论

抑郁障碍和虐待是儿童及青少年自杀未遂的危险因素,在为该人群实施自杀预防策略时应考虑这些因素。

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