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综合医院急诊室自杀未遂患者特征分析

Analysis of features for suicide attempters at emergency departments in general hospitals

摘要目的 调杳自杀未遂患者各种精神障碍的患病率,分析精神障碍自杀未遂患者的临床特征.方法 按市内不同地区分布抽取沈阳市4家三级综合医院进行调查,共调查239例15周岁以上的急诊室自杀未遂患者.调查员在自杀未遂患者经抢救病情好转后用自伤者一般情况表、自伤情况问卷、汉密顿抑郁量表-24项和<美国精神疾病与行为障碍分类与诊断标准>(第4版)科研版轴Ⅰ障碍定式临床检查-病人版进行调查.结果 自杀未遂者自伤当时精神障碍的总患病率为69.46%,其中心境障碍患病率最高(48.12%);有精神障碍者中仅7.23%看过心理或精神科,并接受药物治疗.患有精神障碍的自杀未遂者冲动性自杀少,伤害发牛后自救率低,自伤目的 以解脱痛苦、减轻他人负担为主.患有精神障碍的自杀未遂者的各项抑郁症状及抑郁程度比无精神障碍者更严重(均P<0.05).结论 综合医院急诊室自杀未遂患者精神障碍患病率高,自杀前就诊率低;患有精神障碍的自杀未遂者以非冲动性自杀为主,伤害发生后自救率低,目的 以解脱痛苦、减轻他人负担为主;患有精神障碍的自杀未遂人群自杀与精神障碍中的抑郁成分最直接相关.

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abstractsObjective To investigate the prevalence of various mental disorders of suicide attemplers and analyze the clinical features of suicide attempters with mental disorders. Methods The investigators randomly selected four Class Ⅲ general hospitals from different parts of Shenyang and collected 239 suicide attempters over 15 years old at emergency room. When the conditions of suicide attempters improved after rescue, the investigators studied by suicide general table, self-injury questionnaire, Hamilton Depression Rating Scale for Depression-24 and Structure Clinical Interview for DSM- Ⅳ Axis Ⅰ Disorders-Patient Edition. Results The overall prevalence of mental disorders in attempted suicides was 69.46% while self-injury, one of the highest prevalent mood disorders, accounted for 48. 12%. During the year before suicide, only 7. 23% of the suicide attempters with mental disorders consulted a psychologist or psychiatrist, and took anti-psychosis drugs, anti-depression or anti-anxiety drugs. Suicide attempters with mental disorders often committed suicide less impulsively. And their purpose was to relieve themselves and reduce the burden of others so that the rate of self-help was lower after their injuries occurred; suicide attempters with mental disorders had more obvious symptoms. And their degrees of depression were greater (P < 0. 05 ) than ones without mental disorders. Conclusion The prevalence of mental disorders at emergency rooms in general hospitals is high in suicide attempts, but the pre-suicide consulting rate remains so low. The depressive components of mental disorders are most directly related to suicidal behaviors of suicide attempters.

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中华医学杂志

中华医学杂志

2009年89卷47期

3332-3336页

MEDLINEISTICPKUCSCDCA

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