广西某少数民族农村地区自杀未遂者家庭亲密度和适应性研究
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摘要
目的
     探讨广西某少数民族农村地区自杀未遂流行病学特征。评估自杀未遂者的家庭亲密度和适应性,为对自杀未遂者进行家庭干预提供科学依据。
     方法
     采用以自杀未遂监测和报告系统为基础的非匹配设计的病例对照研究方法。由该系统上报的新发的自杀未遂者组成病例组,计31例。在全县随机抽取15岁以上,并且在研究期间未发生自杀未遂者组成对照组,计81例。以问卷形式,调查病例组自杀未遂流行病学特征,调查病例和对照组人口学特征、精神状况、家庭亲密度和适应性、经历负性生活事件和心理状况等。采用构成比、频数分布等对自杀未遂流行病学特征进行描述分析;采用t检验、秩和检验、方差分析比较病例组与对照组负性生活事件数、慢性心理压力、急性应激强度以及家庭亲密度和适应性的差异。采用t检验分析不同特征人群、不同特征家庭、以及有无各种类型负性生活事件的自杀未遂者家庭亲密度和适应性差异。
     结果
     1.失访的自杀未遂人群较实际调查的自杀未遂人群平均年龄偏小(27.1岁±8.6vs35.8岁±6.5,P=0.005),性别差异无统计学意义(P>0.05)。病例组和对照组合作程度均为最好,提供信息可靠度均为较好。
     2.自杀末遂病例平均年龄35.8±6.5岁,女性占58.1%;壮族29.0%,汉族35.5%,仫佬族35.5%;已婚74.2%,受教育年限为4.3±3.3年。家庭纠纷与经济困难为自杀未遂的主要原因,口服农药(87.1%)为主要自杀方式,54.8%病例自杀前考虑自杀的时间≤2小时,在自杀行为发生前后分别只有25.8%和16.1%的病例因心理问题寻求过帮助。54.8%的病例在自杀行为发生当时有精神障碍;19.4%有自杀未遂史。
     3.病例组经历的负性生活事件较对照组多(P<0.05),慢性心理压力和急性应激强度均高于对照组(P<0.05);家庭亲密度和适应性均低于对照组(P<0.05)。
     4.有“夫妻关系问题”、“和主要家庭成员关系问题”以及“家庭的其他问题”等负性生活事件的自杀未遂者的家庭亲密度和适应性分别低于无此三类负性生活事件的自杀未遂者(P<0.05)。
     结论
     1.广西某少数民族农村地区自杀未遂流行病学特征如下:平均年龄为35.8岁,女性占58.1%,已婚占74.2%,平均受教育年限4.3年;家庭纠纷与经济困难为自杀未遂最主要原因;口服农药为主要自杀方式;54.8%自杀当时有精神障碍;19.4%有自杀未遂史。
     2.通过改善家庭功能,培养个体情感体验;避免家庭负性生活事件的发生,学会疏导释放压力,来提高其家庭亲密度和适应性,可能可以降低自杀未遂的发生。
Objective
     To explore epidemical characteristic of attempted suicide in a minority rural region of Guangxi.To study the family adaptability and cohesion of attempted suicides and provide the reference on family intervention.
     Method
     Unmatched case-control study was conducted based on the attempted suicide monitoring and reporting system. The study was carried out between the case group composed of 31 attempted suicides that were reported by the system and the control group composed of 81 non-attempted suicides in study period that were over the age of 15. Both groups received questionnaires investigation including demographic, mental illnesses, family adaptability and cohesion, life events and psychological status. Only the case group received questionnaires investigation on the epidemical characteristics of attempted suicide. Constituent ratio and frequency distribution were employed to describe the epidemical characteristics. Chi-square test , t test and ANOVA were employed to analyze the differences in family adaptability and cohesion, life events, between two groups. Also t test were employed to analyze the differences in family adaptability and cohesion of attempted suicides in different populations, different families, and different persons who had negative life events or not.
     Results
     1. The average age of missing attempted suicide was lower than that of the investigated (P<0.05) . But no significant difference in gender was found between them. The cooperation levels of the two groups were best. The reliabilities of the two groups were better.
     2. The attempted suicide had a mean of 35.8 years old and a mean of 4.3 years education; 58.1% were female; 29.0% were Zhang nation, 35.5% were Mulao nation, and 35.5% were Han nation. Family dispute and economic difficulties were the most important reason for attempted suicide. Pesticide ingestion was the major way of attempted suicide.25% and 16.1% asked for help because of psychological matter. 54.8% had considered suicide before acting.54.8% had one or two mental illnesses at the time of acting. 19.4% had history of attempted suicide.
     3.Significant differences were found in family adaptability and cohesion, negative life events, chronic mental stress, acute stress between the two groups.
     4. The person who had the negative life events about the relationship with the husband or wife and the major family members, or about the other family problems, gets a lower score of family adaptability and cohesion than the person who hadn't.
     Conclusion
     1. The epidemical characteristic of attempted suicide in a minority rural region of Guangxi were as follows: a mean of 35.8 years old and a mean of 4.3 years of education; 58.1% were female; 74.2% were married; family dispute and economic difficulties were the most important reason for attempted suicide; Pesticide ingestion was the major way of attempted suicide; 54.8% had one or two mental illnesses at the time of acting; 19.4% had history of prior suicide attempt.
     2. Improving family function, calling the experience of feeling, avoiding negative life events about the family, releasing the pressure for improving the family adaptability and cohesion may lower the occurrence of attempted suicide.
引文
1 翟书涛.危机干预与自杀预防[M].北京:人民卫生出版社,1997.
    2 Maris RW,Berman AL,Silverman,MM.Comprehensive Textbook of Suicidology[J].Mew York:The Guilford Predd,2000,30.
    3 肖水源,周亮,徐慧兰.危机干预与自杀预防(二)—自杀行为的概念与分类[J].临床精神医学杂志.2005,15(5):298-299.
    4 World Health Organizations.The world health report 1999.Geneva:WHO.102-103.
    5 United Nations.Prevention of suicide:Guidelines for the formulation and implementation of nation strategies[J].New York,1996.13.
    6 费立鹏.中国的自杀现状及未来的工作方向[J].中华流行病学杂志,2004,24(4):277-279.
    7 Phillips MR,Li XY,Zhang YP.Suicide rates in China,1995-1999[J],Lancet,2002,359:835-840.
    8 殷大奎.齐心协力、脚踏实地、全面推进新世纪精神卫生工作—全国第三次精神卫生工作会议报告[J].中国心理卫生杂志,2002,16:4-8.
    9 北京回龙观医院临床流行病学研究室.2000年3月22-24日举办的“卫生部/WHO自杀预防讲习班”的会议报告[J].中国心理卫生杂志,2000,14(5):285-298.
    10 Beautrais AL,Joyce PR,Mulder RT.Psychiatric illness in a New Zealand sample of young people making serious suicide attempts[J].N Z Med J,1998,111:44-88.
    11 Beautrais AL,Joyce PR,Mulder RT,et al.Prevalence and comorbidity of mental disorders in persons making serious suicide attempts:a case-control study[M];Am J Psychiatry;1996,153:1009-1014.
    12 马长锁,方明昭.自杀未遂者社会心理因素和临床特点对照研究[J].中国心理卫生杂志,1999,13(2):110-112.
    13 张艳萍,李献云,费立鹏,等.农村地区有、无精神障碍自杀未遂者及其自杀特征的比较[J].中国精神科杂志,2003,36(4):234-237.
    14 张振权,余家华,徐庆芬,等.20世纪末广西人口自杀死亡率的流行病学调查研究[J].广西医学,2000,22(6):1177-1180.
    15 蒙增慧,徐东,张艳萍,等.罗城农村人群自杀死亡的流行病学调查[J].疾病控制杂志,2004,8(3):258-259.
    16 梁红,费立鹏.探讨国内生活事件量表的应用[J].中国心理卫生杂志.2005,19(1):42-44.
    17 李献云,费立鹏,张艳萍.评估自杀死亡和自杀未遂者生活事件的重要性[J].中华医学会精神病学分会第七次全国学术年会论文摘要.北京2006.
    18 汪向东主编.心理卫生评定量表手册(增订版)[M],中国心理卫生杂志,314-317.
    19 费立鹏,沈其杰,郑延平,等.“家庭亲密度和适应性量表”和“家庭环境量表”的初步评价[J]冲国心理卫生杂志,1991,5:198-202.
    20 翁正,张敬悬,刘庆贵,等.农村自杀未遂者家庭环境、亲密度及适应性的对照研究[J].中国心理卫生杂志,1996,10(4):148-150.
    21 李献云,许永臣,王玉萍,等.农村地区综合医院诊治的自杀未遂病人特征[J].中国心理卫生杂志.2002,16(10):681-684.
    22 郑延平,翁永振,李光琨,等.中国生活事件调查—(三)不同年龄阶段心理紧张的特点[J].中国心理卫生杂志,1990,4(6):272-274.
    23 贾存显,赵仲堂,徐复秋,等.150例自杀未遂者流行病学研究[J].中国公共卫生,2004,20(6):678-679.
    24 高宏生,曲成毅.167例自杀未遂病例临床流行病学分析[J].山西医科大学学报,2002,33(1):33-35.
    25 薛德旺,马惠郁,费立鹏,等.一所综合医院因自杀急诊者的临床特征分析[J].四川精神卫生,2004,17(2):95-98.
    26 贾存显,赵仲堂,胡茂红,等.自杀未遂危险因素的配对病例对照研究[J].中华流行病学杂志,2005,26(5):339-343.
    27 李桂枝,苏冬彩,徐国银.44例服药自杀未遂者相关因素分析及心理护理对策[J].中华临床医学杂志,2004,5(7):105-106.
    28 魏立和,薛德旺,费立鹏,等.中国老年与青年人自杀死亡特征的分析[J].临床精神医学杂志,2005,15(5):305-306.
    29 郭星君,郭里君.97例农村老年人自杀原因分析[J].使用医药杂志.2007,7(24):849-850.
    30 王志青,王安文,许永臣,等.部分自杀未遂者两年后与社区正常对照比较[J].中国心理卫生杂志,2003,17(12):856-859.
    31 王登勤,张敬悬.自杀未遂者抑郁症状及其相关因素的研究[J].中国心理卫生杂志,2001,15(6):409-410.
    32 李献云,杨荣山,张迟,等.自杀未遂危险因素的病例对照研究[J].中华流行病学杂志.2001,22(4):281-283.
    33 刘连忠,肖水源.生活事件、社会支持与自杀未遂[J].临床精神医学杂志,2002,12(2):103-104.
    [1]翟书涛.危机干预与自杀预防[M].北京:人民卫生出版社,1997.
    [2]Wasserman D.Suicide-an unnecessary death[M].United Kingdom:Martin Dunitz,2001,24-25.
    [3]费立鹏.中国的自杀现状及未来的工作方向[J].中华流行病学杂志,2004,24(4):277-279.
    [4]殷大奎.齐心协力、脚踏实地、全面推进新世纪精神卫生工作——全国第三次精神卫生工作会议报告[J].中国心理卫生杂志,2002,16:4-8.
    [5]梁烨,姜春玲,王志青,等.北京50家综合医院门诊患者自杀意念及自杀未遂调查[J].中华流行病学杂志,2006,27(1):19-24.
    [6]Borges G,Saltijeral MT,Bimbela A,et al.Suicide attempts in a sample of patients from a general hospital[J].Arch Med Res,2000,31:366-372.
    [7]肖水源,王小平,徐慧兰.我国现阶段自杀研究及预防工作中的几个问题[J].中华精神科杂志,2003,36(3):129-131.
    [8]谢巧明.自杀死亡与自杀未遂病人自杀原因及自杀方式比较[J].中国临床心理学杂志,1997,5(1):46-47.
    [9]高宏生,曲成毅.167例自杀未遂病例临床流行病学分析[J].山西医科大学学报,2002,33(1):33-35.
    [10]汤小兰,焦解歌,高宏生.海南琼海市自杀未遂病例流行病学调查[J].疾病控制杂志,2001,5(3):204-206.
    [11]贾存显,赵仲堂,徐复秋,等.150例自杀未遂者流行病学研究[J].中国公共卫生,2004,20(6):678-679.
    [12]贾存显,赵仲堂,胡茂红,等.自杀未遂危险因素的配对病例对照研究[J].中华流行病学杂志,2005,26(5):339-343.
    [13]李桂枝,苏冬彩,徐国银.44例服药自杀未遂者相关因素分析及心理护理对策[J].中华临床医学杂志,2004,5(7):105-106.
    [14]McGuffin P,Marusic A,Farmer A.What can psychiatric genetics offer suicidology?[J]Crisis,2001,22:61-65.
    [15]李琪.自杀的遗传与环境因素.中国行为医学科学,2006,15(8):762-763.
    [16]贾存显,赵仲堂,胡茂红,等.COMT基因多态性与自杀未遂关系研究[J].疾病控制杂志,2004,8(6):551-553.
    [17]马长锁,方明昭.自杀未遂者社会心理因素和临床特点对照研究[J].中国心理卫生杂志,1999,13(2):110-112.
    [18]张艳萍,李献云,费立鹏,等.农村地区有、无精神障碍自杀未遂者及其自杀特征的比较[J].中国精神科杂志,2003,36(4):234-237.
    [19]Beautrais AL,Joyce PR,Mulder RT.Psychiatric illness in a New Zealand sample of young people making serious suicide attempts[J].N Z Med J,1998,111:44-88
    [20]Huong TTT,Guo-Xin J,Tuong NV,et al.Attempted suicide in Hanoi,Vietnam[J].Soc Psychiatry Psychiatr Epidemiol,2005,40:64-71.
    [21]苏敬华,李洁.双相障碍中自杀未遂的危险因素[J].山东精神医学,2006,19(4):311-312.
    [22]Mann JJ,Watemaux C,Haas GL,et al.Toward a clinical model of suicide behavior in psychiatric patients[J].Am J Psychiatry,1999,156(2):181-189.
    [23]张迟,何凤生,费利鹏,等.口服农药自杀未遂者一般情况的病例对照研究[J].医学与社会,2000,13(5):13-15.
    [24]阮冶,姚坚,高长清,等.昆明市四种少数民族村寨宗教习俗与自杀情况调查[J].国际中华神经精神医学杂志,2005,6(3):220-223.
    [25]李光华,陈文明,鲁文兴,等.澜沧县拉祜族、爱尼族对自杀态度的调查[J].临床精神医学杂志,2005,15(4):238-239.
    [26]李光华,陈文明,鲁文兴,等.拉祜族自杀调查分析[J].临床精神医学杂志,2005,15(2):96.
    [27]李献云,杨荣山,张迟,等.自杀未遂危险因素的病例对照研究[J].中华流行病学杂志,2001,22(4):281-283.
    [28]崔树伟,何凤生,费立鹏,等.冲动性人格与自杀未遂的病例对照研究[J].中国公共卫生,2003,19(6):723-724.
    [29]刘连忠,肖水源.生活事件、社会支持与自杀未遂[J].临床精神医学杂志,2002,12(2):103-104.
    [30]翁正,张敬悬,刘庆桂,等.农村自杀未遂者家庭环境、亲密度及适应性的对照研究[J].中国心理卫生杂志,1996,10(4):148-150.
    [31]景璐石,冯军,王绪伦.自杀未遂者的社会心理因素分析[J].中国临床康复,2003,7(18):2602-2603.
    [32]李芳健,何凤生,崔树伟,等.口服农药自杀未遂者的随访研究[J].中国行为医学科学,2004,13(6):643-644.
    [33]王志青,王安文,许永臣,等.部分自杀未遂者两年后与社区正常对照比较[J].中国心理卫生杂志,2003,17(12):856-859.
    [34]王法鑫,孙月吉,刘启贵,等.自杀未遂相关因素分析[J].中国行为医学科学,2002,11(3):288-290.
    [35]李献云,费立鹏,王玉萍,等.冲动性与非冲动性自杀未遂的比较[J].中国神经精神疾病杂志,2003,29(1):27-31.
    [36]Simon OR,Swann AC,Powell KE,et al.Characteristics of impulsive suicide attempts and attempters[J].Suicide Life Threat Behave,2001,32(Suppl 1):49-59.
    [37]贾存显,赵仲堂,潘永峰,等.220例自杀未遂者流行病学特点研究[J].疾病控制杂志,2005,9(1):1-4.
    [38]路英智,董汉振,田明萍,等.农村女性自杀未遂者的相关因素研究 [J].中国心理卫生杂志,2001,15(6):407-408.
    [39]王俊,张红梅,伊茂森,等.自杀未遂者相关因素及其临床特点对照研究[J].山东精神医学,2006,19(4):257-258.

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