Counseling and Psychological Services Center, East China Normal University, Shanghai, China.
Department of Stress Medicine, Faculty of Psychology, Second Military Medical University, Shanghai, China.
BMC Psychiatry. 2021 Sep 28;21(1):474. doi: 10.1186/s12888-021-03480-z.
This study aimed to examine suicide ideation, suicide attempts, and suicide risk by examining a large sample of Chinese university students and identify the predictive factors, including depressive and anxiety symptoms, for suicide attempt and suicide risk.
We recruited 6,836 students (aged 18-30) based on all students enrolled in 2016 from one university using cluster sampling. They completed four questionnaires: the Beck Scale for Suicide Ideation and the Suicidal Behaviors Questionnaire-Revised were used to measure suicide risk, and students' depressive/anxiety symptoms were estimated using Patient Health Questionnaire and Generalized Anxiety Disorder Scale.
Four major findings emerged. First, 18% of the students showed high suicide ideation, 14.5% showed suicide risk, 18.8% had suicide plans, and 1% had attempted suicide. Second, a weak sense of life's value was common among university students, as 61.4% of students considered suicide as a way to end or evade problems. Third, the results of the binary logistic regression showed that education, suicide ideation, including the wish to die, attitude toward suicide, specificity/planning of suicide, and deception or concealment of contemplated suicide were predictive factors of suicide attempt and suicide risk. The variable "deterrents to active attempt" was also a predictive factor of suicide risk. Fourth, depressive and anxiety symptoms did not significantly predict suicide attempts or suicide risk. Only 10.8% and 5.6% of the students had self-reported scores above the clinical cut-off points for depression and anxiety, respectively.
This study highlighted the prevalence of suicide risk among Chinese university students. The high risk of suicide may not only be due to affective disorders, but also a weak sense of life's value or other reasons. Suicide ideation that significantly predicts suicide risk can be used for suicide risk assessment. Universities should provide appropriate life education and suicide prevention and intervention such as teaching instructors gate-keeper skills.
本研究旨在通过对大量中国大学生进行样本调查，研究自杀意念、自杀企图和自杀风险，并确定包括抑郁和焦虑症状在内的自杀企图和自杀风险的预测因素。
我们采用整群抽样的方法，从一所大学 2016 年注册的所有学生中抽取了 6836 名学生（年龄在 18-30 岁之间）进行研究。他们完成了四个问卷：贝克自杀意念量表和自杀行为问卷修订版用于测量自杀风险，学生的抑郁/焦虑症状使用患者健康问卷和广泛性焦虑症量表进行评估。
出现了四个主要发现。首先，18%的学生有较高的自杀意念，14.5%有自杀风险，18.8%有自杀计划，1%有自杀企图。其次，大学生普遍存在生命价值感较弱的情况，61.4%的学生认为自杀是一种结束或逃避问题的方式。第三，二项逻辑回归的结果显示，教育程度、自杀意念，包括想死的愿望、对自杀的态度、自杀的具体性/计划性以及对自杀的欺骗或隐瞒，是自杀企图和自杀风险的预测因素。“自杀行为的阻碍因素”也是自杀风险的预测因素。第四，抑郁和焦虑症状并不能显著预测自杀企图或自杀风险。只有 10.8%和 5.6%的学生的抑郁和焦虑自评分数分别超过了临床临界值。
本研究强调了中国大学生自杀风险的普遍性。高自杀风险不仅可能是由于情感障碍，还可能是由于生命价值感较弱或其他原因。显著预测自杀风险的自杀意念可用于自杀风险评估。高校应提供适当的生命教育和自杀预防和干预措施，如教授门房技能。
