佛山市男男性行为者自杀与冲动性和攻击性的关联分析

Association between impulsivity,aggression,and suicide among men who have sex with men(MSM)in Foshan city

目的了解广东省佛山市男男性行为者(MSM)的自杀情况,探讨其与冲动性和攻击性之间的关系。方法采用同伴推动抽样法在佛山市招募≥18岁的MSM,通过问卷调查获得调查对象的社会人口学信息、自杀、冲动性和攻击性情况。采用无序多分类Logistic回归分析自杀意念和自杀未遂与冲动性和攻击性之间的关系。结果249名MSM估计总体自杀意念率和自杀未遂率分别为30.5%和8.0%。自杀意念组和自杀未遂组的冲动性总分、行动冲动性得分、攻击性总分、自我攻击性得分均高于无自杀意念组(P<0.05);自杀未遂组的攻击性总分、愤怒和敌对得分显著高于自杀意念组(P<0.05)。多因素Logistic回归分析结果显示:高冲动性总分[调整比值比(aOR)=2.2,95%可信区间(CI):1.1~4.7]、高自我攻击性(aOR=4.7,95% CI:1.9~11.6)的MSM更容易产生自杀意念;高行动冲动性(aOR=4.6,95% CI:1.2~17.9)的MSM发生自杀未遂的可能性更大;自杀未遂者与自杀意念者的冲动性和攻击性水平均无统计学差异(P>0.05)。结论佛山市MSM自杀风险较高,与冲动性和攻击性人格特征有关,需结合人格因素对该人群进行自杀风险评估和心理危机预防干预。

Objective To explore the association between impulsivity,aggression and suicide among men who have sex with men (MSM)in Foshan.Methods Respondent-driven sampling (RDS)method was implemented to recruit MSM aged 18years and over,living in Foshan longer than 6 months.All participants were interviewed to collect information on demographics,suicide behaviors,impulsivity and aggression.Multinomial logistic regression analysis was applied to explore the association between impulsivity,aggression and suicide ideation,suicide attempt. Results Among the 249participants,the adjusted lifetime prevalence of suicide ideation and suicide attempt was 30.5% and 8.0% respectively.Individuals with suicidal ideation (ideators)and individuals with suicide attempt (attempters)had higher scores on total impulsivity,motor impulsivity and total aggression,self-aggression (P<0.05) than those without suicide behaviors (no suicide).Moreover,attempters had higher scores on total aggression,anger and hostility (P<0.05)than ideators.MSM with high total impulsivity (aOR=2.2,95% CI:1.1-4.7)and self-aggression(aOR=4.7,95% CI:1.9-11.6)were more like to have suicide ideation,and high motor impulsivity(aOR =4.6,95% CI:1.217.9)were more like to have suicide attempt.There was no significant difference in scores of impulsivity and aggression between ideators and attempters (P>0.05).Conclusion The lifetime prevalence of suicide ideations and suicide attempts are both relatively high among Foshan MSM and might be associated with impulsivity,and aggression.More attention should be paid to impulsivity and aggression in suicide prevention targeting MSM.