某热线12~25岁自杀高危来电者近期自杀未遂的相关因素分析

Factors associated with recent suicide attempts among high-risk callers aged 12-25 to a suicide prevention hotline

目的:比较某自杀预防热线12~25岁自杀高危来电者中仅自杀计划者和两周内实施过自杀未遂者在一般人口学、社会心理学等方面的差异,探索这一高危人群近期自杀未遂的相关因素。方法:将某自杀预防热线在2017—2018年接听的所有12~25岁自杀高危来电者分为两组:自杀计划组(有自杀计划且将在72 h内实施,但两周内无任何自杀行为)和自杀未遂组[在过去两周内(含来电当时)实施过自杀行为]。使用抑郁症诊断筛查量表评估其抑郁程度,询问来电者是否有过酒精或其他物质滥用或依赖、既往自杀未遂史、急性和慢性生活事件等;用logistic回归分析法探究自杀未遂的相关因素。结果:共纳入2 000例12~25岁的自杀高危来电者,其中1 130例(56.5%)来电者报告两周内实施过自杀未遂,纳入自杀未遂组;870例来电者报告有自杀计划且将在72 h内实施(但近两周内未实施过),纳入自杀计划组。与自杀计划组比较,自杀未遂组女性来电者所占比例高,而成年早期(18~25岁)来电者所占比例低(P<0.05)。在调整了性别和年龄等变量后,自杀未遂组中有既往自杀未遂史以及酒精或物质滥用的比例高(P<0.05);其他社会心理学变量,如急性和慢性生活事件、抑郁程度、被虐待史等,在两组间的差异无统计学意义(P>0.05)。结论:有既往自杀未遂和酒精或物质滥用可能是促使12~25岁自杀高危来电者将自杀计划付诸于行动的相关因素;热线工作人员需更多关注具有这些特征的来电者。

Objective:To compare the differences in demographic and socio-psychological factors between those with suicide plans and those with suicide attempts within two weeks among high-risk callers aged 12-25 to a sui-cide prevention hotline,and to explore factors related to recent suicide attempts in this high-risk population.Methods:All high-risk callers aged 12-25 to a suicide prevention hotline between 2017 and 2018 were divided into two groups:the suicide plan group(those having no suicide attempts in the past 2 weeks but with a suicide plan set to be executed within the next 72 hours)and the suicide attempt group(those having suicide attempts in the past 2 weeks or attempting suicide while calling).Their levels of depression were assessed using a depression diagnostic screening scale.Additionally,inquiries were made regarding alcohol or substance misuse,suicide at-tempt history,acute and chronic life events,etc.Logistic regression analysis was used to explore the related fac-tors of suicide attempts.Results:A total of 2,000 high-risk callers aged 12-25 were included.Among them,1,130 callers(56.5%)reported having suicide attempts within past two weeks and were included in the suicide attempt group;870 callers reported having suicide plans set to be executed within 72 hours(with no suicide attempts in the past two weeks)and were included in the suicide plan group.Compared to the suicide plan group,the propor-tion of female callers in the suicide attempt group was higher,while the proportion of young adults(18-25 years old)was lower(P<0.05).After controlling for variables such as gender and age,there was a higher proportion of individuals with suicide attempt history and alcohol or substance abuse in the suicide attempt group(P<0.05).Other socio-psychological variables such as acute and chronic life events,depression,history of being abused,showed no statistically significant differences between the two groups(P>0.05).Conclusion:A history of prior suicide attempts and alcohol or substance misuse may be factors that prompt suicide-risk callers aged 12-25 to act on their suicide plans;hotline operators should pay more attention to callers with these characteristics.