住院重性抑郁发作患者自杀未遂保护性因素的研究

Protective factors against suicide attempt in inpatients with major depressive episode

目的：探讨住院重性抑郁发作（MDE）患者自杀未遂的保护性因素。方法收集当前符合DSM －IV MDE标准的住院患者，进行人口学调查问卷、自杀意念及自杀未遂调查表、汉密尔顿抑郁量表（HAMD）、贝克绝望量表（BHS）、生存理由量表中文版（RFL －C）评定。根据RFL －C来确定在抑郁发作期间可以用来预防或抑制自杀未遂的因素。结果筛查的214例住院情感障碍患者中，101例符合MDE标准。96例纳入最终分析，63例（65．6％）无自杀未遂史。和有自杀未遂史者比，无自杀未遂的患者更多为男性、BHS得分低，而RFL －C总分、生存和应对信念、家庭责任、对自杀的恐惧、对社会排斥的恐惧因子分均高。RFL －C总分及各因子分均与BHS得分呈负相关。结论生存和应对信念、家庭责任、对自杀的恐惧、对社会排斥的恐惧可能是重性抑郁发作患者自杀未遂的保护性因素，较高的RFL －C得分可能抑制绝望观念。

Objective To explore the protective factors of suicide attempts in inpatients with major depressive episode （MDE） .Methods Patients with a current MDE were enrolled ,we collected data through demographic questionnaire ,suicidal idea and suicide attempt checklist ,Hamilton Depression Rat‐ing Scale（HAMD ） ,Beck Hopeless Scale （BHS ） , Reason for Living -Chinese Version （RFL -C ） . RFL -C was used to identify factors which may prevent or restrain suicidal behaviors .Results A total of 214 inpatients with a diagnosis of affective disorders were enrolled ,with 101 of them fulfilled the criteria of DSM -IV based MDE .There were 96 patients included in the final analysis ,with 65 .6% （63） of them without a history of suicide attempts .Patients without suicide history were more likely to be male , had a lower score of BHS ,and expressed more survival and coping skills ,more responsibility toward family ,more fears toward suicide ,and more fear of social exclusion than the depressed patients who had attempted suicide .The total score of RFL -C was inversely correlated with the score of BHS .Conclu‐sions Survival and coping skills ,responsibility toward family ,fears toward suicide ,and fear of social exclusion may be the protective factors of suicide attempt ,and higher score of RFL -C may restrain hopeless idea .