农村青年自杀者精神障碍的识别  

Identification of mental disorders in rural youth suicides

作　　者：周锐[1] 张杰[1,2] 邱惠敏[3] 

机构地区：[1]山东大学公共卫生学院,济南250012 [2]美国纽约州立大学布法罗分院社会学系,布法罗14222 [3]山东省精神卫生中心,济南250014

出　　处：《中国心理卫生杂志》2014年第4期248-252,共5页Chinese Mental Health Journal

基　　金：美国国立卫生研究院资助课题(NIH/NIMH:R01 MH068560)

摘　　要：目的：探讨有效识别农村青年自杀者精神障碍的方法.方法：通过序贯取样的方法,从辽宁、湖南、山东3个省的16个县获得15～34岁自杀死亡病例392例,针对每个病例采用心理解剖方法访谈2个知情人.将中文版DSM-Ⅳ轴Ⅰ诊断临床定式访谈访问卷（SCID-Ⅰ）的回顾性诊断结果与知情人其对自杀者精神障碍的报告进行比较.结果：379例自杀者知情人陈述了死者生前状况,SCID对自杀死亡者生前的精神障碍回顾性阳性诊断率高于知情人对自杀死亡者生前有精神障碍的报告率[48.0％ （188/39）vs.21.9％ （86/392）,P＜0.001].知情人对自杀死亡者生前的精神异常症状的识别率高于对精神障碍的报告率[48.2％ （189/392） vs.21.9％ （86/392）,P＜0.0.001].结论：SCID回顾性诊断是识别农村青年自杀者精神障碍更为有效的方法.相对自杀者的精神障碍,知情人更容易发现自杀者的精神异常症状.Objective： To explore the effective method to identify mental disorder among the Chinese rural youth suicides. Methods： A total of 392 suicide cases aged 15 - 34 years were collected between 2005 and 2008 from 16 rural counties of three provinces （ Liaoning, Hunan, and Shandong） in China. Two informants were inter- viewed for each of the suicides with the psychological autopsy method to assess the life before the suicide. The re- suits of the retrospective diagnose with the Structured Clinical Interview for DSM-IV Axis I Disorders （SCID-I） were compared with the detailed reports of suicide provided by the informants. Results： Informants of 379 suicides provided detailed process of suicide. The positive retrospective diagnosis rate of suicide mental disorder identified by SCID was higher than the recognition rates claimed by informants [48.0% （188/392） vs. 21.9 % （86（/392）, P 〈 0. 001]. The recognition rates of mental symptom by the informants were higher than that of mental disorder [ 48.2% （189/392） vs. 21.9% （86/392）, P 〈 0. 001 ]. Conclusion： The retrospective diagnose with the Structured Clinical Interview for DSM-IV Axis I Disorders （SCID-I） may be effective to detect mental disorder among the Chinese rural youths. It is found that detecting the mental symptom may be easier than detecting mental disorder for informants.

关 键 词：自杀 精神障碍 心理解剖 DSM-Ⅳ轴Ⅰ诊断临床定式访谈访问卷 现况调查 

分 类 号：C913.9[经济管理] R749.04[社会学]