自杀与其它伤害死亡全国性对照研究

National Case-control Study of Suicide and Accidental Death

目的 :了解国内的自杀现状及其特征。方法 :用自制的意外死亡研究问卷按“心理解剖”的调查方法从全国 2 0个农村和 3个城市疾病监测点抽取 895例自杀和 70 1例其它伤害死亡案例。对每个案例的家属及周围知情者单独进行持续约 3小时的调查。结果 :自杀案例中 67%为服毒自杀 (大多数为存放在家中的物品 ) ;63 %自杀当时有精神障碍 (3 9 8%为抑郁症 ) ;2 7%有过自杀未遂 ;91%从未看过精神科医生 ;近一年最常见的负性生活事件为经济困难 (4 0 % )、患急重病 (3 8% )或夫妻不和 (3 5 % ) ;自杀前两天内 2 5 %有突出的人际关系冲突 ;自杀当时 10 %有他人在现场。与其它伤害死亡者比较自杀者女性多、年龄偏大、读书年限少、家庭收入低并出现慢性和急性负性生活事件多。结论 :我国自杀为多因素相互作用的结果 ,相当一部分属于冲动行为 ,与其它国家比自杀当时患精神障碍的比例低。

Objective:Describe the current status and characteristics of suicide in the country.Methods:A survey instrument that uses the psychological autopsy method and took and average of 3 hours to complete was independently administered to family members and associates 895 suicides and 701 accidental deaths from 20 rural and 3 urban Disease Surveillance Points from around the country. Results:The suicides had the following characteristics: 67% died by ingesting poisons (in most cases the poison was stored in the home); 63% had a mental illness at the time of death (most commonly depression); 27% had made a prior suicide attempt; 91% had never seen a mental health professional; in the prior year 40% had serious financial difficulties, 38% had had a serious illness, and 35% had had marital conflicts; 25% experienced an acute interpersonal conflict in the two days prior to death; and 10% committed suicide in the presence of someone else. Compared to persons who died by accidental death, persons who die by suicide are more likely to be female, to be older, have a lower educational level, to have a lower family income and to have experienced more acute and chronic negative life events. Conclusions:Suicidal behavior in China is outcome of the interaction of a number of factors. The proportion of suicides with mental illness is lower than in other countries; a substantial subgroup of suicides are impulsive.