心理援助热线来电者有无自杀意念的自伤行为特征

Characteristics of self-harm behaviors with and without suicidal ideation reported by psychologicalaids hotline callers

目的了解心理援助热线来电者有无自杀意念的自伤行为的差异。方法纳入北京市心理援助热线于2002年12月—2008年12月接听的既往有自伤行为的来电。在通话中询问来电者自伤行为发生时的具体情况。按自杀意念的有无将来电者分为两组进行比较。结果在纳入研究的4423例有自伤史的来电者中,2731例(61.7%)有自杀意念。多元Logistic回归分析结果表明,自伤方法、目的及是否到医院救治与自伤行为是否伴有自杀意念有关。女性[调整后风险比(AOR)=1.17]、自伤后到医院就医(AOR=1.85)、选择坠落、服用治疗药物或其他毒物(AOR=1.77,1.48,1.71)的自伤行为更可能伴有自杀意念;选择割腕或用绳子的方式(AOR=0.72)、以惩罚别人为目的(AOR=0.20)的自伤更不易有自杀意念。结论热线来电者有无自杀意念的自伤行为虽然在自伤特征和相关因素上有所不同,但也有很多相似之处。自杀预防措施中不应该忽视那些无明确自杀意念的自伤行为。

Objectives To understand the differences between self-harm behaviors with and without suicidal ideation among psychological aids hotline callers. Methods All calls to Beijing Psychological Aids Hotline during December 2002 to December 2008 in which callers reported history of self-harm were included in the study. During receiving the calls, hotline operators asked the callers about the specific situation of selfharm behaviors. According to the presence or absence of suicidal ideation, the self-harm callers were divided into two groups to compare. Results Among the 4 423 callers with self-harm history, 2 731( 61.7%) of them had suicidal ideations. Multivariate logistic regression indicated that the self-harm method, purpose and whether being treated in hospital were associated with suicidal ideation among self-harm callers. Self-harm callers who are female( AOR=1.17), who sought for medical treatment after self-harm( AOR=1.85), choosing to fall, taking therapeutic drugs or other poisons( AOR=1.77,1.48,1.71) were more likely to have suicidal ideation. People engaging self-harm by cutting wrist or the rope( AOR=0.72) and for the purpose of punishing others( AOR=0.20) were less likely to have suicidal ideation. Conclusions Hotline callers' self-harm behavior with or without suicidal ideation differs in self-harm characteristics and related factors, but there are also many similarities. Suicide prevention measures should not overlook those self-harm without clear suicidal ideation.