住院精神分裂症患者自杀未遂行为临床特征对照研究

A control study about the clinical features of attempted suicide behavior in inpatient with schizophrenia

目的了解住院精神分裂症患者自杀未遂行为的临床特征。方法回顾性分析225例精神分裂症患者,其中自杀组72例,非自杀组153例。用自编临床资料收集表登记一般资料,评定入院时简明精神病量表总分及各因子分,及汉密尔顿抑郁量表总分,比较两组一般资料及各量表评分。结果自杀组中有家族史(69.4%)、既往有自杀未遂史(52.7%)、病前有社会应激事件(56.9%)、起病形式为急性或亚急性(70.8%)、合并躯体疾病(68.0%)、有物质滥用(12.5%)、治疗依从性差(76.4%)、无社会保险(77.8%)所占比例明高于非自杀组,两组比较有显著性差异(P<0.01)。BPRS总分及焦虑抑郁因子分、思维障碍因子分、敌对猜疑因子分,自杀组明显高于非自杀组(P<0.05)。HAMD总分自杀组明显高于非自杀组(P<0.01)。自杀组中存在抑郁症状者的比例(70.8%)明显高于非自杀组(19.6%)(P<0.01)。结论精神分裂症患者的自杀未遂行为的临床特征较为明显,是可以提前预测及早预防的。

Objective To investigate the clinical features of attempted suicide behavior in inpatients with schizophrenia. Methods 225 cases with schizophrenia were analyzed retrospectivly. General information were the patients were assessed with Brief Psychiatric Rating （72 cases in suicide group and 153 cases in non-suici collected by using self-designed clinical data questic Scale （BPRS） and Hamilton Depression Rating Scale de group） naire. All （HAMD） at the admission. The general information and the scores of BPRS and HAMD were compared between suicide group and non-suicide group. Results Compared with non-suicide group, the incidence of positive family history （69.4%）, history of attempted suicide （ 52.7% ）, social stress events before onset （ 56.9% ）, being acute or subacute onset （70.8%）, comorbiding with physical disease （68. 0%）, comorbiding with substance abuse （12. 5% ）, poor compliance （76.4%）, lack of social insurance （77.8%） in suicide group were significantly higher （P 〈0.01 ）. Total score of BPRS and factor score of anxiety ＆ depression, factor score of thought disorder, factor score of hostile suspicion in suicide group were significantly higher than those in non-suicide group （P 〈 0.05）. Total score of HAMD in suicide group were significantly higher than those in non-suicide group （ P 〈 0.01 ）. The ratio of presence of depressive symptoms in suicide group was significantly higher than that in control group （ 70.8% vs. 19.6% , P 〈 0.01 ）. Conclusion Schizophrenics with attempted suicide behavior have apparent clinical features. So, the suicide behavior should be predicted and prevented in advance.