中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
20期
2300-2304,2305
,共6页
廖震华%王文强%丁丽君%洪旭%纪淑娇%王玉真%李秀灼%周建清
廖震華%王文彊%丁麗君%洪旭%紀淑嬌%王玉真%李秀灼%週建清
료진화%왕문강%정려군%홍욱%기숙교%왕옥진%리수작%주건청
抑郁症%自杀意念%自杀未遂%横断面研究
抑鬱癥%自殺意唸%自殺未遂%橫斷麵研究
억욱증%자살의념%자살미수%횡단면연구
Depressivedisorder%Suicidalideation%Suicide,attempted%Cross-sectionalstudies
目的:探讨社区重性抑郁障碍患者自杀意念和自杀未遂发生情况及影响因素。方法采用多阶段分层整群随机抽样法,选择厦门市仙岳医院2010年5-11月进行的精神障碍流行病学调查部分资料。实际抽样12071例,其中10764例完成调查,完成率为89.17%。最终2155例需进行诊断检查,共发现并确诊重性抑郁障碍患者145例,其中现患63例,既往发作82例。收集并分析其人口学特征及相关影响因素。结果重性抑郁障碍患者男56例,女89例,自杀意念发生率为42.8%(62/145),其中女性有过自杀意念41例,发生率为46.1%〔95%CI(0.36,0.56)〕,男性有过自杀意念21例,发生率为37.5%〔95%CI(0.25,0.50)〕,差异无统计学意义〔χ2=1.03,P=0.31,OR=1.42,95%CI(0.72,2.80)〕。自杀未遂发生率为9.6%(14/145),其中7例女性患者自杀未遂,发生率为7.9%〔95%CI(0.02,0.14)〕,7例男性患者自杀未遂,发生率为12.5%〔95%CI(0.04,0.21)〕,差异无统计学意义〔χ2=0.83,P=0.36,OR=0.60,95%CI(0.20,1.81)〕。正规受教育年限≥7年人群自杀意念发生率低于0~6年,农村人群自杀意念发生率低于城镇;外地户籍人群自杀未遂发生率高于本地户籍,年家庭人均收入﹥8000元人群自杀未遂发生率高于≤8000元人群(P﹤0.05)。疲倦或精力缺失和无价值感或自罪感两项症状阳性者自杀意念发生率高于阴性者,而思考或集中注意力障碍症状阳性者自杀未遂发生率低于阴性者( P﹤0.05)。多因素Logistic回归分析显示,正规受教育年限≥7年〔OR=0.39,95%CI(0.16,0.95)〕,居住地在农村〔OR=0.32,95%CI(0.14,0.71)〕为自杀意念的保护因素,而疲倦或精力缺失阳性〔OR=2.91,95%CI(1.04,8.11)〕为自杀意念的独立危险因素( P﹤0.05)。外地户籍〔OR=4.91,95%CI(1.57,15.31)〕为自杀未遂的独立危险因素( P﹤0.05)。结论重性抑郁障碍患者自杀意念和自杀未遂的发生率较高;受教育程度、居住地和精神症状疲倦或精力缺失为影响自杀意念的独立因素,而户籍为影响自杀未遂的独立因素。
目的:探討社區重性抑鬱障礙患者自殺意唸和自殺未遂髮生情況及影響因素。方法採用多階段分層整群隨機抽樣法,選擇廈門市仙嶽醫院2010年5-11月進行的精神障礙流行病學調查部分資料。實際抽樣12071例,其中10764例完成調查,完成率為89.17%。最終2155例需進行診斷檢查,共髮現併確診重性抑鬱障礙患者145例,其中現患63例,既往髮作82例。收集併分析其人口學特徵及相關影響因素。結果重性抑鬱障礙患者男56例,女89例,自殺意唸髮生率為42.8%(62/145),其中女性有過自殺意唸41例,髮生率為46.1%〔95%CI(0.36,0.56)〕,男性有過自殺意唸21例,髮生率為37.5%〔95%CI(0.25,0.50)〕,差異無統計學意義〔χ2=1.03,P=0.31,OR=1.42,95%CI(0.72,2.80)〕。自殺未遂髮生率為9.6%(14/145),其中7例女性患者自殺未遂,髮生率為7.9%〔95%CI(0.02,0.14)〕,7例男性患者自殺未遂,髮生率為12.5%〔95%CI(0.04,0.21)〕,差異無統計學意義〔χ2=0.83,P=0.36,OR=0.60,95%CI(0.20,1.81)〕。正規受教育年限≥7年人群自殺意唸髮生率低于0~6年,農村人群自殺意唸髮生率低于城鎮;外地戶籍人群自殺未遂髮生率高于本地戶籍,年傢庭人均收入﹥8000元人群自殺未遂髮生率高于≤8000元人群(P﹤0.05)。疲倦或精力缺失和無價值感或自罪感兩項癥狀暘性者自殺意唸髮生率高于陰性者,而思攷或集中註意力障礙癥狀暘性者自殺未遂髮生率低于陰性者( P﹤0.05)。多因素Logistic迴歸分析顯示,正規受教育年限≥7年〔OR=0.39,95%CI(0.16,0.95)〕,居住地在農村〔OR=0.32,95%CI(0.14,0.71)〕為自殺意唸的保護因素,而疲倦或精力缺失暘性〔OR=2.91,95%CI(1.04,8.11)〕為自殺意唸的獨立危險因素( P﹤0.05)。外地戶籍〔OR=4.91,95%CI(1.57,15.31)〕為自殺未遂的獨立危險因素( P﹤0.05)。結論重性抑鬱障礙患者自殺意唸和自殺未遂的髮生率較高;受教育程度、居住地和精神癥狀疲倦或精力缺失為影響自殺意唸的獨立因素,而戶籍為影響自殺未遂的獨立因素。
목적:탐토사구중성억욱장애환자자살의념화자살미수발생정황급영향인소。방법채용다계단분층정군수궤추양법,선택하문시선악의원2010년5-11월진행적정신장애류행병학조사부분자료。실제추양12071례,기중10764례완성조사,완성솔위89.17%。최종2155례수진행진단검사,공발현병학진중성억욱장애환자145례,기중현환63례,기왕발작82례。수집병분석기인구학특정급상관영향인소。결과중성억욱장애환자남56례,녀89례,자살의념발생솔위42.8%(62/145),기중녀성유과자살의념41례,발생솔위46.1%〔95%CI(0.36,0.56)〕,남성유과자살의념21례,발생솔위37.5%〔95%CI(0.25,0.50)〕,차이무통계학의의〔χ2=1.03,P=0.31,OR=1.42,95%CI(0.72,2.80)〕。자살미수발생솔위9.6%(14/145),기중7례녀성환자자살미수,발생솔위7.9%〔95%CI(0.02,0.14)〕,7례남성환자자살미수,발생솔위12.5%〔95%CI(0.04,0.21)〕,차이무통계학의의〔χ2=0.83,P=0.36,OR=0.60,95%CI(0.20,1.81)〕。정규수교육년한≥7년인군자살의념발생솔저우0~6년,농촌인군자살의념발생솔저우성진;외지호적인군자살미수발생솔고우본지호적,년가정인균수입﹥8000원인군자살미수발생솔고우≤8000원인군(P﹤0.05)。피권혹정력결실화무개치감혹자죄감량항증상양성자자살의념발생솔고우음성자,이사고혹집중주의력장애증상양성자자살미수발생솔저우음성자( P﹤0.05)。다인소Logistic회귀분석현시,정규수교육년한≥7년〔OR=0.39,95%CI(0.16,0.95)〕,거주지재농촌〔OR=0.32,95%CI(0.14,0.71)〕위자살의념적보호인소,이피권혹정력결실양성〔OR=2.91,95%CI(1.04,8.11)〕위자살의념적독립위험인소( P﹤0.05)。외지호적〔OR=4.91,95%CI(1.57,15.31)〕위자살미수적독립위험인소( P﹤0.05)。결론중성억욱장애환자자살의념화자살미수적발생솔교고;수교육정도、거주지화정신증상피권혹정력결실위영향자살의념적독립인소,이호적위영향자살미수적독립인소。
Objective Toexplorethesuicideideaandattemptsofpatientswithmajordepressivedisorders(mDD) andtheirinfluencingfactors.Methods Weusedamulti-stagestratifiedclusterrandomsamplingmethodtoinvestigatepartof the data of mental disorder epidemiology in Xiamen from may to November 2010. A total of 12 071 cases were selected actually, 10 764 of whom completed the investigation(89. 17%),and 2 155 of whom needed diagnosis checks,which found 145 mDD patients including 63 suffering mDD now,82 having had episodes before. The demographic characteristics and related factors wereanalyzed.Results TheoccurrencerateofsuicideideaofmDDpatientswere42.8%(62/145),including41females〔46. 1%,95%CI(0. 36,0. 56)〕,21 males〔37. 5%,95%CI(0. 25,0. 50)〕,which was not significantly different〔χ2 =1. 03,P=0. 31,OR=1. 42,95%CI(0. 72,2. 80)〕. The occurrence rate of suicide attempts was 9. 6%(14/145),in-cluding 7 females〔7. 9%,95%CI(0. 02,0. 14)〕,7 males〔12. 5%,95%CI(0. 04,0. 21)〕,the difference was not significant〔χ2 =0. 83,P=0. 36,OR=0. 60,95%CI(0. 20,1. 81)〕. The suicide attempt rate was lower in those with≥7 year formal education than in those with 0-6 year formal education,lower in rural group than in urban group,higher in foreign permanent population than in local permanent population,higher in group with ﹥8 000 Yuan of household incomes per capita than in group with ≤8 000 yuan(P﹤0. 05),higher in groups positive in symptoms of tiredness or lack of energy and of feeling of worthlessness or guilt than in groups negative in the above-mentioned symptoms(P﹤0. 05). multivariate Logistic regression analysis showed that ≥7 year formal education〔OR=0. 39,95%CI(0. 16,0. 95)〕,rural place of residence〔OR=0. 32, 95%CI(0. 14,0. 71)〕were protective factors of suicide idea,tiredness or lack of energy〔OR =2. 91,95%CI(1. 04, 8. 11)〕was an independent risk factor of suicide idea(P﹤0. 05). Foreign census register was an independent risk factor influ-encingsuicideattempts〔OR=4.91,95%CI(1.57,15.31),P﹤0.05〕.Conclusion Theoccurrenceofsuicideideaand attempts is high in mDD patients. Educational level,residence place,tiredness or lack of energy are independent factors of sui-cide idea,household registration is an independent factor influencing suicide attempts.