精神分裂症患者与非精神分裂症患者自杀的特征和危险因素比较。
Characteristics and Risk Factors for Suicide in People with Schizophrenia in Comparison to Those without Schizophrenia.
机构信息
Weifang Medical University School of Public Health, China.
Shandong University Center for Suicide Prevention Research, China; State University of New York College at Buffalo Department of Sociology, USA.
出版信息
Psychiatry Res. 2021 Oct;304:114166. doi: 10.1016/j.psychres.2021.114166. Epub 2021 Aug 8.
BACKGROUND
Little research has been conducted that compares suicide cases with and without schizophrenia. The aim of the present study was to identify demographic, personal, social, relational, and psychological characteristics among suicides identified posthumously with schizophrenia compared to those without.
METHODS
The DSM-IV was used to independently assess the presence of schizophrenia among suicide cases by two psychiatrists. Data on risk factors was collected through a psychological autopsy method, which included structured interviews of two informants for each suicide case (a family member and a close friend). Interview questions included demographic characteristics, suicide risk factors, the Beck Hopelessness Scale, Dickman's Impulsivity Inventory, the Spielberger State-Trait Anxiety Inventory, the Hamilton Depression Scale and the Duke Social Support Inventory.
RESULTS
The prevalence of schizophrenia was 9.69% among suicide cases in this sample. The schizophrenia suicide group was more likely to be female, older, in poorer physical health, suffer from chronic disease, suffer other psychological disorders, and have a family history of psychological disorders compared to those not diagnosed schizophrenia. Other important risk factors included more frequent past suicide attempts, increased levels of depression and anxiety, lower levels of impulsivity, lower help seeking from friends, and lower social interaction social support.
CONCLUSIONS
There is a notable link between schizophrenia and suicide in China. Identification of social, personal, relational, and psychological risk factors could beneficially guide attempts to improve future preventive measures against suicide among those with schizophrenia in China.
背景
鲜有研究比较伴有和不伴有精神分裂症的自杀案例。本研究旨在识别在死后被诊断为患有精神分裂症的自杀者与没有被诊断为精神分裂症的自杀者之间存在的人口统计学、个人、社会、关系和心理特征。
方法
通过两位精神科医生使用 DSM-IV 独立评估自杀案例中精神分裂症的存在情况。通过心理解剖方法收集风险因素的数据,该方法包括对每个自杀案例的两位知情人(家庭成员和亲密朋友)进行结构化访谈。访谈问题包括人口统计学特征、自杀风险因素、贝克绝望量表、迪克曼冲动性量表、斯皮尔伯格状态-特质焦虑量表、汉密尔顿抑郁量表和杜克社会支持量表。
结果
本样本中自杀案例中精神分裂症的患病率为 9.69%。与未被诊断为精神分裂症的自杀者相比,精神分裂症自杀组更可能为女性、年龄更大、身体健康状况较差、患有慢性疾病、患有其他心理障碍,并且有心理障碍家族史。其他重要的风险因素包括过去自杀未遂的频率更高、抑郁和焦虑水平升高、冲动性水平降低、向朋友寻求帮助的次数减少以及社交互动和社会支持减少。
结论
在中国,精神分裂症与自杀之间存在显著联系。识别社会、个人、关系和心理风险因素可以有益地指导中国针对精神分裂症患者未来预防自杀的措施。