冲动性人格特征与农村地区自杀未遂的关系

Impulsiveness and suicide attempts in rural areas

目的探讨冲动性人格特征与自杀未遂的关联。方法从我国4个农业县的自杀行为医院登记系统获取自杀未遂案例,从其中3个县分层随机抽样获取健康对照者。分别访谈案例对象本人、家属和亲友,收集案例对象的人口学资料、精神健康情况、冲动人格特征和攻击行为等信息。结果共有118例自杀未遂案例(未遂组)和140例健康对照者(对照组)被纳入研究。未遂组[(40.3±13.0)岁]较对照组[(49.7±13.9)岁]年轻(P <0.001),女性比例更高(66.1% vs 46.4%,P=0.002)。单因素分析未遂组的冲动性量表总分和攻击行为总分的高分比例均高于对照组。多因素Logistic回归结果提示,依据知情人报告的信息,冲动性量表总分高(OR=59.56,95% CI:10.80~328.40)或该量表的认知冲动分量表高分(OR=10.49,95% CI:2.20~49.98)和行为冲动分量表高分(OR=5.63,95% CI:1.41~22.59)是升高自杀未遂的风险;依据本人提供信息,认知冲动分量表高分(OR=3.55,95% CI:1.09~11.54)和自我攻击分量表得分中等(OR=4.14,95% CI:1.33~12.88)是升高自杀未遂的风险。结论冲动人格特征是自杀未遂的独立危险因素。需要采取生命价值观教育和其他综合措施减少"冲动"自杀行为。

Objective To discuss the association between impulsiveness and suicide attempts in rural areas.Methods Suicide-attempt(SA)cases were extracted from suicidal behavior register system at the emergency departments of general hospitals in 4 rural counties.Healthy-control cases(HC)were randomly sampled from the corresponding 3 counties.The patients and their family members,friends or relatives were interviewed to obtain the information of demographics,mental health,impulsiveness,and aggressive behaviors.Results The study enrolled 118 SAS and 140 HCS.Compared with HCS,the SAS were younger(40.3±13.0 years vs 49.7±13.9 years;P<0.001),and were likely being females(66.1%vs 46.4%,P=0.002).The results of bivariate analysis showed that SAS had higher proportion than HCS in the high-level(third tertile)scores in the Barratt’s Impulsiveness Scale(BIS-11)and the Buss-Perry Aggression Questionnaire(BPAQ).Results of multivariate logistic regression analysis based on proxy reported data demonstrated that high-level total scores in BIS-11(OR=59.56,95%CI:10.80-328.40)or in the cognitive subscale(OR=10.49,95%CI:2.20-49.98)or motor subscale of BIS-11(OR=5.63,95%CI:1.41-22.59)conferred higher risk for suicide attempts.Based on self-reported data,high-level score on cognitive subscale of BIS-11(OR=3.55,95%CI:1.09-11.54)and mediumlevel score on the self-aggressive subscale of BPAQ(OR=4.14,95%CI:1.33-12.88)elevated suicide attempt risk.Conclusion After controlling confounders,impulsiveness is an independent risk factor for suicide attempts.Public education of life values and other comprehensive intervention strategies should be applied to reduce impulsive suicidal behavior.