山东省不同人群自杀死亡的特征:3种流行病学研究方法比较  

Characteristics of suicide mortality in different populations of Shandong province: A comparison of three epidemiologic study methods

作　　者：张敬悬[1] 张艳[1] 翁正[1] 

机构地区：[1]山东省精神卫生中心,山东省济南市250014

出　　处：《中国组织工程研究与临床康复》2007年第52期10543-10546,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:了解山东省自杀死亡率及其在不同人群中的分布特征,以及自杀者的自杀原因、自杀方式及其家庭结构特征。方法:①于1988-01/1992-12对山东城乡8个观察区进行前瞻性定群观察,由乡村医生提供线索,精神科医生深入现场收集资料,1998年观察区人口为468343人,至1992年结束时观察区人口为479438人。采用随机分层整群抽样和精神科医生入户调查研究方法,在全省15个地市进行自杀死亡流行病学抽样调查,共调查人口84767人。在前瞻性研究观察区内,通过乡镇卫生院抢救记录为线索,调查74例自杀未遂者,并在其同村按同性别、同年龄组1∶1选择正常对照,进行病例对照研究。②调查被调查者的性别、年龄、职业等一般资料。用家庭环境量表评估病例-对照研究中的自杀未遂者和对照组的家庭环境,该量表包括10个因子,分值较高者表明更具备该因子特征。结果:①自杀率差异:前瞻性定群观察中≥15岁人群年平均自杀死亡率为22.32/10万,女性自杀死亡率27.36/10万明显高于男性17.26/10万(χ2=21.64,P<0.01)。抽样调查结果为年平均自杀死亡率16.66/10万。女性自杀死亡率20.52/10万明显高于男性12.72/10万(χ2=3.86,P<0.05)。②自杀原因和方式差异:前瞻性定群观察、抽样调查、病例-对照研究结果中主要自杀原因均为家庭纠纷(58.9%,45%,64%)和精神疾病(11.1%,24%,9%)。主要自杀方式均为服毒(62.2%,67%,90%)。③家庭环境比较:病例-对照结果显示,自杀未遂者家庭的亲密度、文化性、娱乐性和组织性较对照组差,而矛盾性较对照组突出。结论:3种流行病学方法研究结果均显示,山东省自杀死亡率在女性中居高,自杀原因以家庭纠纷为主,而主要自杀方式则为服毒;自杀者的家庭存在较多的功能缺陷。AIM： To investigate the mortality of suicide in Shandong province and the distribution among different populations, and study the evoking factors and ways of suicide together with the family structure. METHODS： （1）A prospective cohort study was performed in 8 areas of Shandong province from January 1988 to December 1992, with the clues of rural doctors and the data collected by psychiatric physicians. There were 468 343 residents in 1998 and 479 438 residents in 1992 among 8 observational areas. According to the rescuing records of rural health center, 74 suicide uncompleters were selected for a case-control study, while 72 subjects who matched in gender and age were taken as normal control group. A total of 84 767 subjects from 15 cities of Shandong province were examined by an epidemiologic survey, adopting random stratified sampling in cluster and the investigation by psychiatric physicians.（2）All the testees were surveyed for gender, age and occupation, etc. Family environment scale of 10 factors was used to evaluate the suicide uncompleters and normal controls. RESULTS： （1）The mortality of suicide in population of 15 years old and above were 22.32 per 1 000 000 in the group of cohort study and 16.66 per 1 000 000 in the group of sampling survey. The suicide mortality of females was obviously higher than that of males in the cohort study group （27.36, 17.26 per 1 000 000, Х^2=21.64, P 〈 0.01）, and the sampling study group was the same （20.52, 12.72 per 1 000 000, Х^2==3.86, P 〈 0.05）.（2）The commonest evoking factors of suicide were family conflict （58.9%, 45%, 64%） and mental disorder （11.1%, 24%, 9%）, and the mainly way of suicide was taking poison （62.2%, 67%, 90% ）. （3）The result of case-control study showed that, the factor scores of cohesion, intellectual-cultural orientation, active-recreational orientation and organization in the family of suicide were lower than those in the family of control group, while the factor score of conflict in suicide famil

关 键 词：自杀 自杀死亡率 流行病学 家庭 

分 类 号：R395[哲学宗教—心理学]