山东省农村居民生活事件精神刺激水平与自杀未遂的关联研究

The relationship between mental stimulation level of life events and suicide attempt of rural residents in Shandong Province

目的探索山东省农村居民生活事件精神刺激水平与自杀未遂的关系.方法采用1∶1配对病例对照研究设计,从山东省农村地区3次自杀未遂调查中获取病例1 200例.按以下配对因素选择对照:年龄相差3岁以内;同性别;同村或邻村;无血缘关系;无既往自杀史.通过问卷调查收集研究对象基本特征并测量其生活事件精神刺激水平.采用多因素条件logistic回归模型分析生活事件精神刺激水平与自杀未遂的关系.结果病例组和对照组年龄均为(36.6±0.3)岁,各组男性均占35.8%(430名).病例组负性生活事件精神刺激水平为中低水平和高水平者分别占16.7%(200/1 200)和61.7%(740/1 200),均高于对照组的2.5%(30/1 200)和29.3%(352/1 200)(P值均<0.05).病例组具有正性生活事件精神刺激者占11.1%(133/1 200),低于对照组的16.8%(201/1 200)(P值<0.05).多因素logistic回归模型分析显示,调整性别、年龄、居住地、教育水平、婚姻状况、职业、家庭年收入、躯体疾病、精神障碍、亲属自杀史和对立生活事件等因素后,中低水平和高水平负性生活事件精神刺激量均为自杀未遂的危险因素,OR(95%CI)值分别为5.88(4.53~7.64)和13.94(8.15~23.86);正性生活事件精神刺激为自杀未遂的保护因素,OR(95%CI)值为0.58(0.41~0.82).结论负性和正性生活事件精神刺激分别是自杀未遂的危险因素和保护因素.

Objective To explore the relationship between the level of mental stimulation and the suicide attempts of rural residents in Shandong Province. Methods A 1:1 matched case-control study was designed to collect 1 200 cases from a survey of three suicide attempts in rural areas of Shandong Province. Controls were selected according to the following matched factors: age difference within 3 years, same gender, same village or neighboring village, no blood relationship, no suicide history. The basic characteristics of all subjects were collected through the questionnaire, and the level of mental stimulation of life events was measured. Multivariate conditional logistic regression model was used to analyze the relationship between the level of mental stimulation of life events and suicide attempts. Results The mean age of the case group and the control group was both (36.6±0.3) years old, and 35.8%(430/1 200) were males in each group. The low-medium level of mental stimulation of negative life events in the case group was 16.7%(200/1 200) and 61.7%(740/1 200), respectively, which was higher than that in the control group, about 2.5%(30/1 200) and 29.3%(352/1 200)(all P values<0.05), respectively. A total of 11.1%(133/1 200) of the case group had positive life events, which was lower than that of the control group [16.8%(201/1 200)](all P values<0.05). Multivariate logistic regression model analysis showed that after the adjustment of gender, age, place of residence, education level, marital status, occupation, family income, somatic disease, mental disorders, family history of suicide, and opposite life events, the low-medium and high level of mental stimulation of negative life events were risk factors for suicide attempts, with OR (95%CI) as 5.88 (4.53-7.64) and 13.94 (8.15-23.86), respectively. Mental stimulation of positive life events was protective factor of suicide attempts, with OR (95%CI) as 0.58 (0.41-0.82). Conclusion Mental stimulation of negative and positive life events were risk and protective factors for suicide attempts.