有自杀意念与自杀未遂的女性罪犯缓解期抑郁障碍防御方式及人格障碍倾向的对照研究

Defense Style and Personality Disorder Tendency of Female Criminals with Remission Depressive Disorder of Suicidal Ideation and Attempts: A Control Study

目的探讨有自杀意念及自杀未遂的缓解期抑郁障碍女性罪犯患者防御方式及人格障碍倾向性特征,为预防罪犯自杀行为提供依据。方法对广西某监狱在押女性罪犯进行横断面普查,确诊为缓解期抑郁障碍患者138例,其中有自杀意念及自杀未遂62例(自杀组)、无自杀意念、无自杀未遂76例(无自杀组),采用防御方式问卷(DSQ)及人格障碍诊断问卷(PDQ-4+)对两者患者进行测评。结果自杀组更多地使用投射、潜意识显现、抱怨、分裂、退缩、躯体化等不成熟的防御方式和假性利他、隔离、消耗倾向等中间型防御方式,而较少使用升华等成熟防御方式。自杀组患者中人格障碍PDQ-4+阳性率为58.06%(36/62),显著高于无自杀组28.95%(22/76)(P<0.01)。自杀组在PDQ-4+的边缘型、偏执型、被动攻击型、分裂型、抑郁型、反社会型、强迫型人格障碍得分明显高于无自杀组(P均<0.05)。结论女性罪犯抑郁障碍患者心理防御机制方面的缺陷、人格障碍的共病是导致患者自杀的重要危险因素。

Objective To explore the characteristics of defense style and personality disorder in the female criminals with remission depressive disorder of suicidal ideation and attempts ,and to provide the basis for preventing the criminals from suicide .Methods The female criminals in a prison of Guangxi were investigated by the cross-sectional survey.One hundred and thirty-eight patients with remission depressive disorder were enrolled in the study ,including 62 patients with the symptoms of suicidal ideation and attempts （ suicidal group ） and 76 patients without the symptoms of suicidal ideation and attempts（no suicidal group）.Defensive style questionnaire（DSQ） and personality diagnostic questionnaire-4＋（ PDQ-4＋） were used to evaluate the patients in two groups .Results The patients in the suicidal group tended to use the immature defense style such as projection ,acting out ,complaint ,schizophrenia,flinch,somatization as well as the intermediate defense style such as pseudo-altruism,isolation and consumption tendency,but less used the mature defense style such as sublimation .The positive rate of personality disorder PDQ-4＋of suicidal group was significantly higher than that of no suicidal group [58.06%（36/62） vs 28.95%（22/76）,P〈0.01].The scores of 7 subscales of PDQ-4＋in the suicidal group were significantly higher than those in the no suicidal group （all P〈0.05）.Conclusion The imperfection of psychological defense mechanism and personality disorder is responsible for the suicide in the female criminals with remission depressive disorder .