社区自杀意念者中精神卫生问题及相关因素分析

Mental health problems and determinants among people with suicidal ideations in community

目的：分析社区曾经存在自杀意念者中现患的精神卫生问题及影响因素。方法：资料来自2001年浙江省精神疾病流行病学调查,该文利用SPSS 15.0统计分析软件,进行卡方检验,二分类logistic回归分析,复杂抽样统计描述（Complex Samples Crosstab）和logistic回归分析（Complex Samples Logistic Regression Analysis）。结果：调查到的14634人中有615例自报有自杀意念,未调整精神卫生问题（GHQ-12总分≥3）的时点患病率60.33%;调整抽样设计因素后,时点患病率为57.42%（95%CI：52.72%~61.99%）。调整抽样设计因素,复杂抽样logistic回归分析显示精神卫生问题显著并独立地与自我报告躯体健康差、低家庭年收入、低受教育年限和阳性自杀家族史有关。在这些危险因素中,自我报告躯体健康差对自杀意念者中精神卫生问题的影响最大,其次是低家庭年收入和低受教育年限。结论：该结果是初步的、探讨性的而非结论性的,结果中所显示的自杀意念者中精神卫生问题和危险因素的关系已经提示了临床意义并为人群干预提供了可能。

Objective To analyse current mental health problems and correlates among community subjects with lifetime suicidal ideations.Methods Data for this study came from a cross sectional psychiatric survey conducted in 2001 in Zhejiang province and analyses of this paper is limited to those who self-reportedly ever had suicidal ideations in their lifetime.Results Among the randomly selected 15,000 subjects who were 15 years older or above,14,634（98%） completed the survey.Among 615 who were identified with suicidal ideations in their lifetime,the unadjusted point prevalence of mental health problems（defined as GHQ-12 total scores ≥3） was 60.33%.The adjusted point prevalence was 57.42%（95% CI： 52.72-61.99%） after adjustment for sampling and cluster effect.Complex Samples Logistic analysis revealed that in individuals with suicidal ideations,mental health problems were significantly and independently associated with self-reportedly poorer physical health,lower yearly family income,lower schooling years and positive family history of suicidal behaviours after adjustment for sampling and cluster effect.Among these identified risk factors,poor physical health was the greatest contributor to mental health problems,followed by low yearly family income and low schooling years.Conclusion These results are only preliminary,exploratory not conclusive.The associations of mental health problems and correlates have suggested the clinical significance and potential intervention for the population with suicidal ideations.