中国3省部分农村地区15～34岁青年自杀死亡特征群病例对照研究

Suicidal characteristic-clusters for rural young victims aged 15-34 in three provinces, China： a case controlstudy

目的探讨农村15～34岁青年自杀死亡分类及其特征群。方法采用心理解剖方法和分类树对山东、辽宁和湖南省16个县的392例自杀死亡者和416例对照进行研究，自杀组和对照组均采用2名信息人进行资料收集。结果农村青年自杀死亡分类的主要参考因素为：对未来的感觉、对未来的期望、精神疾病、寻求指引和支持；其标准化重要性分别为100、97、91、76；其中，绝望情绪（包括对未来的感觉、对未来的期望）比精神疾病重要性高出6～8分。农村青年自杀死亡可分成5类，其中最主要的两类为绝望情绪严重者、绝望情绪并不严重的精神病患者，分别占64．8％、11．8％。该自杀分类树的判别效果良好，其灵敏度为84．34％，特异度为92．08％。结论对于自杀风险的筛查及自杀预防工作，进行绝望感的评估比精神疾病的筛查更具有指导意义。

Objective To explore the categories on suicide and their characteristic-clusters among rural young people of Chinese aged 15-34 in three provinces to provide evidence for suicide prevention. Methods A total number of 392 suicidal deaths and 416 live controls sampled from 16 counties of Shandong, Liaoning, Hunan provinces in China, were included in this study. Psychological Autopsy and Classification Tree methods were employed. Two informants were interviewed to collect the information of each subject. Results Expectation on future, mental disease, seeking guidance and support were important factors for the classification of suicide among rural young population, and their scores of standardized importance were 100,97,91 and 76, respectively. Desperation （including feeling about the future and expectation） seemed to be more important than mental disease, with 6-8 more scores on standardized importance. Five categories of rural young suicides were determined. Desperate people or patients with mental disease but with less desperation were the main two categories, accounting for 64.8% and 11.8% respectively. Sensitivity and specificity of this classification tree were 84.34% and 92.08% , respectively. Conclusion For programs on suicide screening and prevention, evaluation on desperation seems more significant than screening on mental disease.