安徽医学生自杀行为与儿童青少年期自杀史相关性

Association between the early history of suicide behaviors in childhood or early adolescent and suicidal behaviors in the last year among college students

目的探讨儿童及青少年早期自杀行为与大学生近期自杀行为的关系，为预防大学生自杀的发生提供依据。方法以安徽省3所医学院校大一、大二年级共10297名学生作为研究对象，采用自编问卷调查15岁之前自杀行为史、不良经历史以及一二级亲属自杀死亡、未遂和意念史，同时调查过去1a自杀行为发生情况。结果10297名大学生中，15岁之前发生自杀意念、未遂的人数分别为516（5．0％）和63（0．6％）人；近1a内发生自杀意念和自杀未遂的人数分别为360（3．5％）和33（0．3％）。15岁之前的自杀意念史与近1a自杀意念、自杀未遂的关联指标OR值分别为4．0（95％CI=3．0～5．4）和6．1（95％CI=3．1～12．0）；15岁之前的自杀未遂史与近1a自杀意念、自杀未遂的关联指标OR值分别为4．2（95％CI=1．4—12．5）和114．0（95％CI=51．3～253．2）。调整人口学、亲属自杀以及ACEs变量后，上述关联均出现一半以上的下降，但除15岁之前自杀意念史与近1a自杀未遂关联没有统计学意义外，其余关联仍均有统计学意义。结论儿童及青少年早期自杀行为史，尤其是自杀未遂史可能是大学生近期自杀行为独立的危险因素。

Objective To examine the associations between the early history of suicidal behaviors in childhood or early ad- olescent and suicidal behaviors in the last year among college students after adjustment for adverse childhood experiences （ ACEs ） and family history of suicidal behaviors. Methods A total of 10 297 college students from three medical college schools in Anhui province were administered to complete the questionnaire concerning the history of suicidal behaviors before age 15, ACEs, family history of suicidal behaviors, and suicidal behaviors in last year. Results Of the 10 297 participants, 516 （5.0%） and 63 （ 0.6% ） reported having suicidal ideation and attempt before age 15, respectively. Three hundred and sixty （ 3.5% ） and 33 （0.3%） reported having suicidal ideation and attempt in last year, respectively. Suicidal ideation before age 15 was associated with suicidal ideation （ OR=4. 0, 95% CI：3.0-5.4） and attempt （ OR=6.1, 95% CI：3.1-12.0） . Suicidal attempt before age 15 was associated with suicidal ideation （ OR = 4.2, 95 % CI： 1.4-12.5 ） and attempt （ OR = 114.0, 95 % CI：3.1 - 12.0 ）. After ad- justment for sociodemographic characteristics, the history of relative, and ACEs, the association between suicidal ideation before age 15 and suicidal attempt in last year was insignificant, other associations above were all significant. Conclusion The history of suicidal behaviors, especially suicidal attempt seem to be independent risk factors.