北京市心理援助热线有精神障碍诊断史求助者的特征

Characteristics of Beijing Psychological Crisis Hotline callers with the diagnosis of mental disorders

目的：分析北京市心理援助热线有精神障碍诊断来电者的特征，以便有针对性地为他们提供热线心理干预服务。方法：应用北京市心理援助热线电脑咨询操作系统收集的资料进行统计分析。数据为2002年12月-2008年12月间拨打北京市心理援助热线的24217例来电者，根据来电者自我报告是否有精神机构就医诊断史将其分为有精神障碍诊断史组（n=6516）和无精神障碍诊断史组（n=17701），比较两组在求助问题类型、人口学特征及自杀相关因素上的差异性。结果：有精神障碍诊断组咨询的前五位问题为精神疾病、精神疾病相关知识、家庭关系、工作问题及家庭外的人际关系，在两组中，精神疾病问题均为首个咨询问题；相比之下，女性、20～29岁和30—44岁两个年龄组、教育年限≥10年和非现职者更多见于有精神障碍诊断组。来电者11个自杀相关因素评估结果显示，有精神障碍诊断史组在来电时的自杀意念或行为、既往自杀未遂史、高抑郁情绪、严重躯体疾病、受虐待史、害怕被攻击、亲友自杀行为史、高无望感的出现率均高于无精神障碍诊断史组（P〈0．001或0．05）。结论：热线咨询员对有精神障碍诊断的来电者进行热线干预时要特别注意评估来电者的抑郁程度以及其他自杀相关因素；为这些人群提供帮助时，要注意识别和处理他们生活中各种应激事件。

Objective： To understand the characteristics of the callers with the diagnosis of mental disorders called Beijing Psychological Crisis Hotline for help, in order to provide specific psychological intervention services for them in future. Methods： From December 2002 to December 2008, 24217 different callers＇data collected from a computer-based operating system of the Beijing Psychological Crisis Hotline were analyzed. According to their self- reported of having the diagnoses of mental disorder or not, the callers were divided into the ones with diagnosis （n = 6516） and the ones without diagnosis （n = 17701）. The callers＇demographic characteristics, their main counseling problems and the suicide-related factors in the two groups were compared. Results： The top five main counseling problems in the group with diagnosis were mental problems, the mental illness related knowledge, the problems of family relationships, working problems and interpersonal problems. Mental problem ranked first in both groups. Compared to the group without diagnosis, the diagnosed ones were more likely to be found in such group of people as women, aged between 20 - 29 and 30 - 44, having 10 or more years of education and the unem- ployed. The results of the assessments of 11 suicide-related risk factors showed that callers with diagnoses had higher prevalence of most suicide-related factors than those in the other group（P 〈 0. 001 or 0. 05）, which included suicidal intention and behavior while calling, history of attempted suicide, severe depressive symptoms, severe physical illness, history of being abused, afraid of being attacked, suicidal history of relatives or associates, severe of hopeless. Conclusion： The hotline counselors should be aware of the necessity of assessing the severity of depression and other suicide-related factors for the callers with mental disorder diagnoses before providing any psychotogical intervention. Moreover, except for providing interventions on the callers＇ psychiatric problems, the hotline counselors should also identify and help to deal with the stress events in their lives.