农村居民儿少期不良经历与自杀及自杀未遂的关系  

Association between adverse childhood experiences and suicide and attempted suicide among rural residents

作　　者：袁雪凤[1] 陈瑶 闵婧 童永胜[2] Yuan Xuefeng;Chen Yao;Min Jing;Tong Yongsheng(Department of Rehabilitation,Beijing Huilongguan Hospital,Beijing 100096,China;WHO Collaborating Center for Research and Training in Suicide Prevention,Beijing Huilongguan Hospital,Beijing 100096,China)

机构地区：[1]北京回龙观医院康复科,北京100096 [2]北京回龙观医院世界卫生组织心理危机预防研究与培训合作中心,北京100096

出　　处：《广西医科大学学报》2023年第10期1640-1645,共6页Journal of Guangxi Medical University

基　　金：北京市医院管理中心临床医学发展专项经费资助项目(No.ZYLX202130);北京市医院管理中心“登峰”计划专项项目(No.DFL20221701)。

摘　　要：目的:探讨农村居民儿少期不良经历与其成年后自杀及自杀未遂行为之间的关联。方法:从4个农业县的死因报告系统和综合医院自杀行为登记系统获取自杀死亡、意外死亡和自杀未遂案例,在其中3个农业县分层随机抽取健康居民作为对照组;每个研究对象都有两名知情人接受访谈,使用儿童期虐待问卷和一个自编的不良经历问卷了解研究对象16岁以前的不良经历以及有关信息。结果:共有151例自杀、118例自杀未遂、157例意外死亡、140例健康对照完成研究访谈;自杀组16岁之前有不良家庭环境比例(22.0%)高于其他3组(12.7%、8.9%,14.4%),差异具有统计学意义(χ^(2)=11.03,P=0.012),有不良事件经历比例(34.4%)亦高于其他3组(22.9%、19.7%、22.7%),差异具有统计学意义(χ^(2)=10.40,P=0.015);调整了性别、年龄等变量后,16岁以前的不良家庭环境是自杀的危险因素(与意外死亡比较,AOR=3.59,P=0.001;与自杀未遂比较,AOR=2.13,P=0.045),但与自杀未遂的关联无统计学意义(AOR=0.89,P=0.768)。结论:16岁以前的不良家庭环境会增加成年后自杀死亡风险,改善儿童青少年的生活环境应被纳入农村地区自杀预防策略。Objective:To explore the association between adverse experiences in childhood and suicide and attempted suicide in adulthood among rural residents.Methods:Cases of suicide death,accidental injury death and attempted suicide were collected from the cause of death reporting system and general hospital suicidal behavior registry system in four agricultural counties.Healthy residents were randomly selected from three agricultural counties as the control group.Two proxy informants of each recruited participant were interviewed using a Childhood Trauma Questionnaire(CTQ),and a self-compiled Family Maltreatment Questionnaire to gather information about the participants’adverse experiences before 16 years old and related details.Results:A total of 151 suicides,118 suicide attempts,157 accidental injury death,and 140 healthy controls were selected to complete the research interviews.The proportion of poor family environment before 16 years old in the suicide group(22.0%)was higher than that in the other three groups(12.7%,8.9%,14.4%),and the difference was statistically significant(χ^(2)=11.03,P=0.012).The proportion of experiencing adverse events in the suicide group(34.4%)was also higher than that in the other three groups(22.9%,19.7%,22.7%)and the difference was statistically significant(χ^(2)=10.40,P=0.015).After demographic variables such as gender and age were adjusted,adverse family environment before 16 years old was a risk factor for suicide(compared with accidental death,AOR=3.59,P=0.001;compared with attempted suicide,AOR=2.13,P=0.045),but there was no significant difference in the association with attempted suicide(AOR=0.89,P=0.768).Conclusion:Adverse family environment before16 years old increases the risk of suicide in adulthood.Improvement home environment for children and adolescents should be taken into consideration in suicide prevention strategies in rural areas.

关 键 词：自杀 自杀未遂 不良经历 儿童期 

分 类 号：R749[医药卫生—神经病学与精神病学]