大连市农村居民自杀死亡情况及所致经济负担和心理影响的研究

Economic and psychological burden of suicide in the country of Dalian

目的:研究2000年大连市金州和庄河地区自杀的流行病学特点、寿命损失、死亡经济负担值以及精神负担情况。方法:自杀死亡的资料来源于2000-02/2001-07大连市金州和庄河两地的县级医院、乡卫生院、村卫生所登记在册的自杀已遂病例,共66例。对照组以性别、年龄和居住地域为匹配指标进行选择,共66例。被访人是农村自杀死亡者的亲友,共330例。从人口学角度分析自杀造成的生命年的损失;从微观角度分析自杀给患者家庭经济造成的影响,从宏观角度分析自杀给社会造成的经济影响;从心理学角度分析自杀给亲友造成的精神负担。结果:①大连市金州与庄河地区自杀流行病学特点:2000年自杀已遂的66例人口中,男女比为2.67:1;自杀者年龄以15～34岁和>60岁者居多;自杀组家庭年收入明显少于对照组。②自杀死亡所致的生命年损失:自杀已遂者的潜在寿命损失年为1949.22人年,平均每例自杀的潜在寿命损失为29.53人年;其中35～39岁年龄组的潜在寿命损失最大。标准期望减寿年数共计2560.16人年;其中25～55岁年龄组的标准期望寿命损失最大。减少伤残调整寿命1401.48人年,其中35～39年龄组损失的值最大。③自杀死亡经济负担的核算:自杀死亡病例家庭未来收入损失的总现值为2027.547万元,平均每个家庭的损失为30.720万元,损失最大的年龄?

AIM:To investigate the epidemiology,life lost,economice and psychological burden of suicide in the country of Jinzhou and Zhuanghe areas in Dalian city.METHODS:The targets came from 66 cases of suicide death in prefectural hospitals and village clinics, which occurred in the country of Zhuanghe and Jinzhou in Dalian city from February 2000 to July 2001.Sixty six people matched in sex,age and inhabited area were selected as controls. The whole informer accounted for 330 and they were all the relatives and friends of suicides.The present study described the years of life lost demographically,estimated the economic impact of suicide deaths on their families and society microcosmically and macroscopically respectively,and analyzed the psychological effects of suicide deaths on the relatives and friends by using the psychological scale.RESULTS:①The epidemiological features in Jinzhou and Zhuanghe in Dalian city listed as follows:For the 66 suicide deaths reported,the rate of male to female was 2.67:1.The curve of age showed two pinnacles: 15-34 years and over 60 years.The family outcome was less in the suicide group than the control group.②The potential years of life lost(PYLL) in the 66 cases of suicide were 1 949.22 person years, averagely 29.53 years for one case,which was the severest in the group of 35-39 years.Standard expectancy PYLL counted up to 2 560.16 person years, and the severest was the group of 25-55 years.Disability adjusted life years(DALY) were 1 401.48 person years,and the severest was the group of 35-39 years.③For the 66 suicide deaths reported, direct cost for the future family income was $20 275 470.83,averagely $307 204.10 for each family.The loss of family income was the severest in the group of 35-39 years.According to the method of Barnum,the direct cost for social economic was $62 379 709.61,averagely $945 147.115 2 for each suicide case. The suicide group of 15-44 years resulted in the most pecuniary loss.The total loss of social economic due to DALY was $19 732 838.40,averagely $298 982.40 for each case.The suicide group of 15-44 years resulted in the most pecuniary loss.④The psychological impact due to suicide death and its related factors were studied.Informers showed different attitudes toward the death of different gender.To women,the attitude was more tolerant than that to men.Female informers had no difference in the attitude to the suicide death of different gender; however,male informers were more tolerant to the female suicide.People accepted the suicide resulting from incurable disease more and that resulting from bankruptcy less.The relatives showed the strongest disagreement to the action of suicide and higher frequency of the occurrence of depression than the others. CONCLUSION:The most significant impact of a suicide death on the economic cost of families in the country of Zhuanghe and Jinzhou in Dalian city is great,suicide deaths affect society by consuming both human lives and economic resources,and suicide puts psychological pressure on relatives.It is important to study the epidemiology, the economical burden and the psychologyical burden of suicide in order to offer a backgroud for establishing the strategy of suicide prevention.