抑郁症的自杀未遂及其危险因素分析

An analysis of attempted suicide in major depression and the associated risk factors

为了获得抑郁症病人的自杀未遂发生率及其危险因素，采用自制的抑郁症与自杀的关系登记表和Ｈａｍｉｌｔｏｎ抑郁量表，分别对符合中国精神疾病分类方案与诊断标准第２版修订本的２１２例住院的抑郁症病人进行调查评分，然后用ＳＰＳＳ和ＰＥＭＳ软件包进行统计分析。结果：在２１２例抑郁症病人中发生自杀观念１５８例（７４．５％），自杀未遂６７例（３１．６％）。在自杀未遂组中的自杀方式以过量服药为主（４７．８％），自杀地点多在室内（７７．６％）。自杀未遂组的抑郁症状评分高于无自杀行为组（ｔ＝７．２７，Ｐ＜０．０１）。自杀与绝望感、抑郁情绪、自卑感、自知力等呈正相关。逐步回归分析发现，绝望感对自杀的影响最大，其次是抑郁情绪，再次是自卑感和自知力。提示抑郁症与自杀的关系密切，频繁出现≥３次自杀观念的抑郁症病人发生自杀行为的可能性较大。

The study was designed to examine the prevalence of attempted suicide in patients with major depression and the associated risk factors. A self-design register form for depression and suicide, and Hamilton Depression rating scales (HAMD) were used in 212 inpatients who met the diagnostic criteria for major depression, described in the revision of the 2nd edition of the Chinese Classification and Diagnostic Criteria of Mental Disorders (CCMD-2-R). SPSS and PEMS procedures were used to perform all statistic analyses. Among 212 patients, 158 cases (74.5%) had suicidal idea and 67 cases (31.6%) had attempted suicied. Taking overdose drugs (47.8%) was the main pattern of suicide. Most of suicide (77.6%) took place inside the rooms. The mean total HAMD scores was significantly higher in attempted suicide subgroup than in non-suicide subgroup. A significantly positive correlation of attempted suicide and hopelessness, depression, inferiority complex and insight in HAMD was noted. The stepwise regression analysis showed that important risk factors involved in attempted suicide were hopeless, depression, inferiority complex and insight shown in HAMD, successively. There was a close relationship between major depression and attempted suicide. The suicide incidence of patinents with frequent suicidal idea was higher than that of those without suicidal idea.