心理援助热线求助者自杀企图的特征及相关因素分析

Analysis of the characteristics and correlated factors of attempted suicide in psychological aid hotline callers

目的探讨心理援助热线求助者自杀企图的特征及相关因素，为国内心理援助热线自杀预防和干预提供参考依据。方法厦门心理援助热线2010年9月至2015年8月接听来电中，将1299例有自杀企图相关资料的求助者纳入研究。来电过程中评估求助者抑郁情绪和其他精神症状，并询问其物质滥用、躯体问题、生活事件、亲友自杀史、无望感、被虐待史、害怕被攻击等自杀相关因素情况。结果1299例求助者中，有自杀企图求助者361例（27．8％），既往有自杀未遂史223例（17．2％）。不同性别、年龄段、职业的求助者自杀企图发生率均差异无统计学意义（均P〉0．05）。1024例（78．8％）评估有精神症状，其中794例（61．1％）评估有焦虑症状，708例（54．5％）评估有抑郁症状，864例（66．5％）求助者合并存在2项及以上症状；比较抑郁伴发其他精神症状的求助者自杀企图发生率，发现抑郁伴发焦虑症状、伴发强迫症状、伴发惊恐症状及伴发恐惧症状自杀企图发生率均有统计学差异（均P〈0．05）。多因素Logistic回归分析显示，高抑郁情绪（β=0．389，OR=1．48，95％CI=1．08—2．02，P=0．015）、既往自杀未遂史（β=0．487，OR=1．63，95％CI=1．19～2．22，P=0．002）、高无望感（β=0．618，OR=1．86，95％CI=1．32～2．60，P〈0．01）与求助者自杀企图有关联。结论对于有自杀企图的求助者，注意评估他们精神症状的伴发情况，高抑郁情绪、既往自杀未遂史、高无望感等特征，以便有针对性进行自杀干预和预防。

Objective To analyze the characteristics and correlated factors of attempted suicide among psychological aid hotline callers, and provide a reference for suicide prevention and intervention to the domestic psychological aid hotlines. Methods From September,2010 to August,2015, 1 299 callers who had the database of attempted suicide among hotline callers were collected.During the calling, the callers were interviewed on their attempted suicides, depression and 10 correlated factors associated with caller＇ s suicidal behaviors. Results Among 1 299 callers who received assessment of suicidal behavior relates factors, 361 （27.8%） had evaluated of current suicidal ideation or behavior, 223 （ 17.2% ） had history of prior suicidal attempts.There was no significant difference in the incidence of suicide attempts among different gender,age and occupation. 1 024 （ 78.8% ） had symptoms of mental illness, 794 （ 61.1% ） had symptoms of anxiety, 708 （54.5%） had symptoms of depression,864（66.5%） had concomitant two or more symptoms. Compared the caller＇ s occurrence rate of suicidal attempter between single depression and concomitant other symptoms, the results found single depression and concomitant anxiety, concomitant obsession, concomitant panic and concomitant fear were statistically significant.Multiple logistic regression analysis showed that high depression emotion （β= 0.389, OR= 1.48,95% CI= 1.08-2.02 ） , the history of prior attempted suicide （β= 0.487, OR = 1.63,95%CI= 1.19-2.22） and high hopelessness （β= 0.618, OR= 1.86,95%CI= 1.32-2.60） were associated with the caller of ever attempted suicide behaviors. Conclusion Among the callers with attempted suicide, in order to improve the effectiveness of hotline prevention and invention, the psychological consultant should focus on the evaluation of concomitant mental symptoms, high depression emotion, history of prior attempted suicide and hopelessness.