冲动性与非冲动性自杀未遂的比较

The comparison of impulsive and non-impulsive attempted suicide

目的 自杀未遂是我国重要的公共卫生问题,但缺乏针对性的、有效的干预措施。本研究通过比较冲动性与非冲动性自杀未遂的特征,为制定相应的预防措施奠定基础。方法 对4所市县级综合医院的306例病情较重的自杀未遂病人用自制调查表进行调查。按其自杀前考虑自杀时间的长短人为地分为冲动性(≤2小时,164例)和非冲动性(>2小时,142例)两组,并对两组进行比较。结果 两组在许多方面有显著差异。用非条件Logistic回归分析控制不同因素之间的相互影响后,发现在自杀未遂者中,自杀前2周抑郁程度越轻、自杀意图强度越低,有急性(≤1月)负性生活事件、自杀前1个月生命质量越高、居住在乡村、越年轻越易发生冲动性自杀行为;而性别和其他因素与冲动性自杀行为的发生无关。结论 冲动性与非冲动性自杀未遂的特征明显不同,对这两种不同的自杀未遂人群是否应采取不同的预防及干预措施是目前迫切需要解决的问题。

Objective Attempted and completed suicide are an important public health problem for China, but we are lacking effective preventive interventions. As a first step to developing targeted interventions, this study compared the characteristics of impulsive and non-impulsive attempted suicides. Methods We developed a detailed questionnaire for attempted suicides and administered it to 306 persons who were treated for suicide attempts in the emergency rooms of four general hospitals. Based on the time they had considered suicide before acting, the patients were categorized as ' impulsive' ( ≤2 hours, n = 64) and ' non-impulsive'( > 2 hours; n = 142) and then the characteristics of the two groups of patients were compared. Results Using unconditional logistic regression analysis to control the interactions of many factors that were different between the two groups identified six characteristics of suicide attempters that independently predict imppulsive suicide attempts (in order of importance): lower depression symtpom score, lower suicidal intent; negative life event in prior month; higher overall quality of life, rural residence, and younger age. Conclusions The characteristics of impulsive and non-impulsive suicide attempters are different. We urgently need to determine whether or not these two types of suicide attempters require different types of preventive interventions.