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酒精性自杀与抑郁非酒精性自杀在近期生活事件上的差异。

Differences in recent life events between alcoholic and depressive nonalcoholic suicides.

作者信息

Heikkinen M E, Aro H M, Henriksson M M, Isometsä E T, Sarna S J, Kuoppasalmi K I, Lönnqvist J K

机构信息

Department of Mental Health, National Public Health Institute, Helsinki, Finland.

出版信息

Alcohol Clin Exp Res. 1994 Oct;18(5):1143-9. doi: 10.1111/j.1530-0277.1994.tb00095.x.

Abstract

The purpose of this study was to investigate the main differences in recent life events preceding suicide between alcoholic and depressive nonalcoholic suicide victims, how much these differences were sex- and age-dependent, and how social support varied between these groups. Using the psychological autopsy method, retrospective best-estimate diagnoses by DSM-III-R criteria were assigned to a randomized 16.4% sample (n = 229) of suicide victims drawn from a 1-year total nationwide suicide population (n = 1,397) in Finland. Life events during the last 3 months (32 items) and social support (6 items) of 75 suicide victims with alcohol abuse/dependence diagnoses were compared with those of 69 nonalcoholic depressive victims. Among male suicides, the alcoholics had experienced more separations and family discord, financial trouble, and unemployment, whereas the depressives had experienced more somatic illness. Among females, adverse interpersonal events had been common in both alcoholic and depressive victims. Among the alcoholics, unlike the depressives, the number of adverse interpersonal life events had not diminished with increasing age. Living alone had been twice as common among the alcoholic suicides and, in these cases, recent separation, unemployment, and financial trouble were remarkably common, suggesting a concurrent stressor effect. Our results confirm and extend the earlier findings of excess interpersonal stressors among alcoholic suicides compared with depressive suicides. The findings suggest that multiple adverse life events and living alone need to be taken into account in clinical practice when assessing psychosocial stress and suicidal danger in alcoholism.

摘要

本研究的目的是调查酗酒自杀受害者与抑郁非酗酒自杀受害者近期自杀前生活事件的主要差异,这些差异在多大程度上取决于性别和年龄,以及这些群体之间的社会支持情况如何。采用心理解剖方法,根据《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)标准,对从芬兰全国一年自杀总人数(n = 1397)中随机抽取的16.4%样本(n = 229)自杀受害者进行回顾性最佳估计诊断。将75名有酒精滥用/依赖诊断的自杀受害者在过去3个月的生活事件(32项)和社会支持(6项)与69名非酗酒抑郁受害者的情况进行比较。在男性自杀者中,酗酒者经历了更多的分居和家庭不和、经济困难及失业,而抑郁者经历了更多的躯体疾病。在女性中,酗酒和抑郁受害者都普遍存在不良人际事件。在酗酒者中,与抑郁者不同的是,不良人际生活事件的数量并未随着年龄增长而减少。酗酒自杀者中独居的情况是其他自杀者的两倍,在这些案例中,近期的分居、失业和经济困难非常普遍,这表明存在并发应激源效应。我们的结果证实并扩展了早期的研究发现,即酗酒自杀者比抑郁自杀者存在更多的人际应激源。研究结果表明,在临床实践中评估酒精中毒患者的心理社会压力和自杀危险时,需要考虑多种不良生活事件和独居情况。

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