自杀未遂者的临床特征和精神障碍诊断  

Characteristics and mental disorder diagnosis of suicide attempters

作　　者：苏中华[1] 李秀英[1] 高慧敏[1] 李婕[1] 张现峰[1] 柳群方[1] 王志青[2] 

机构地区：[1]济宁医学院第二附属医院,济宁272051 [2]北京回龙观医院

出　　处：《中华行为医学与脑科学杂志》2012年第1期47-49,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：基金项目：美国中华医学基金会项目（CMB05-813）

摘　　要：目的探讨自杀未遂患者的临床特征及精神障碍的诊断，为自杀未遂的心理危机干预策略提供参考。方法对232例自杀未遂者，以自杀未遂个案调查表收集自杀的行为特点，以自杀强度问卷评估自杀强度，以美国精神障碍诊断与统计手册第四版轴I障碍临床定式检查病人版（SCID／I-P）进行精神障碍诊断。结果（1）232例自杀未遂者中，女性多于男性，男女比例为1：2．87，16～35岁者所占比例最高（56．9％）；服毒（83．2％）是最常见的自杀方式，91．4％的自杀发生在家中；家庭纠纷是诱发自杀的首要原因（61．2％），其次为情绪低落（15．1％），再次为恋爱问题（9．5％）；（2）自杀前83．6％的自杀未遂者未考虑是否被发现，84．1％的未采取任何防止被他人发现的措施，超过60．0％的没有自杀意向的言语流露，90．0％左右的无遗言、遗书或安排后事；自杀时，62．9％的身旁无人或未与人联系；约60．0％的自杀目的是想死，控制他人者仅为7．3％；（3）232例自杀未遂者精神障碍诊断率为45．3％，其中心境障碍最为常见。结论自杀未遂者的自杀行为特征未有明显改变，自杀强度中等，有相当大比例的自杀者可能系冲动性自杀者，精神疾病与自杀的关系更加密切。Objective To understand the behavioral characteristics, strength on suicide ideation and mental disorder diagnosis among suicide attempers, so as to provide consultation for crisis intervention of suicide. Methods 232 suicide attempters from emergency of 5 general hospital in south-west of Shandong province were enrolled. They were assessed using questionnaires on attempted suicide behaviors and scale on the strength of suicide ideation,and were diagnosed using the Structured Clinical Interview for DSM-IV Disorders axis I for patient （SCID/I-P）. Results （1） In the total of 232 cases, female was more than male with the gender ratio of 2.87 （ female vs male）. The highest proportion rate （56.9%） existed between 16 years old to 35 years old. Oral application pesticide was the most commom suicide pattern （83.2%） ,91.4% of the suicide attempt occurred in the their homes. The top three reasons leading to suicide were family contrary （61.2%） ,depressive mood （15.1%） and fail in love （9.5%）. （2） In all cases,83.6% did not think if they were found,84.1% did not adopted any precaution measures, over 60.0% did not tell anyone their attempted plans, and 90% had no dying struetions and / or dying testaments before their attempted behaviors. At the moment of attemp behaviors ,62.9% did not contact with someone. The 60.0% of all the cases had wanted strongly to die, otherwise 7.3% had wanted to manipulate others. （3） The diagnosis rate of mental disorder on DSM-IV was 45.3% ,in which the mood disorder was most. Conclusion There are no changes on the behavioral characteristics among the suicide attempters in the south-west rural area of Shandong province. Their strength of suicide ideation are moderate, and a certain proportion of suicide attempters may be impulsive suicide attempters. There is more relationship between mental disorder and suicide attempt.

关 键 词：自杀未遂 临床特征 精神障碍诊断 

分 类 号：R749.3[医药卫生—神经病学与精神病学]