重复与单次自杀行为者的生活满意度、应对方式及社会支持

目的:比较重复与单次自杀行为者生活满意度主观感受方面的差异,了解重复与单次自杀行为者出院后不同时期应对方式和社会支持情况,丰富自杀干预理论素材。方法:用生活满意度主观评价条目询问115例住院自杀行为者对自杀5年前、1年前、1个月前、当前、自杀1个月后、1年后、5年后生活满意度,并在其出院18个月、3年、5年时,采用应对方式问卷(CSQ)和社会支持评定量表(SSQ)施测。将有自杀未遂史及出院后6年内再次出现自杀的列为重复自杀行为者,并与单次自杀行为者比较。结果:24例重复自杀行为者就诊住院时对不同时期生活满意度(当前满意度除外)主观评价及累加总分均低于91例单次自杀行为者[如总分(18.9±3.6)vs.(22.6±4.0);均P<0.05]。出院后3年、5年时评定,重复自杀行为者CSQ中的退避、自责、幻想得分高于单次自杀行为者,而CSQ中的解决问题、求助及SSQ的主观支持、支持利用度、支持总分低于单次自杀行为者(均P<0.05)。将应对方式、社会支持、主观满意度分别放入与精神疾病等变量进行logistic回归分析,结果患有精神疾病者(OR=3.39～7.68,均P<0.05)有较高的重复自杀风险,而同时将上述变量一起多因素logistic回归分析,所有变量与重复自杀的相关均无统计学意义(均P>0.05)。结论:相对单次自杀行为者,重复自杀者生活满意度主观评价低,应对方式不良,社会支持差,且具有持续性。精神疾病与生活满意度、应对方式、社会支持相互影响,这些因素中,精神疾病与重复自杀的联系可能更紧密些。     

微信群延续干预对永久性肠造口患者术后早期社会心理适应和生活质量的影响

目的:探讨微信群延续性干预对永久性肠造口患者术后早期社会心理适应和生活质量的影响。方法:以2015年10月-2016年8月我院收治的86例永久性肠造口术后患者为对象,随机数字表法均分为对照组和观察组各43例,对照组术后接受常规干预,观察组在此基础上另实施微信群延续性干预,观察干预前后两组早期社会心理适应量表(OAI-20)评分、自我护理能力实施量表(ESCA)评分、生活质量问卷(COHQOL-OQ)量表评分及出院3个月后并发症发生情况。结果:与出院时相较,出院后3个月两组正性情绪、负性情绪及社会生活适应评分、生理维度、心理维度、社会维度和精神维度评分明显升高,差异显著(t_(观察组)=18.003,28.973,18.280,4.433,5.299,6.889,7.932;t_(对照组)=8.814,15.543,10.616,2.235,3.142,4.678,5.011;P0.05),并且观察组各项指标的升高幅度较对照组明显(t=8.498,17.216,8.309,2.390,2.295,2.421,3.106;P0.05);出院后1、3个月两组ESCA评分明显升高,差异显著(F=8.923,7.502;P0.001),观察组升高幅度较对照组明显(F=6.852,P0.05);出院后3个月观察组并发症发生率11.63%较对照组34.88%明显低,差异有统计学意义(χ~2=6.515,P0.05)。结论:微信群延续性干预可有效提高永久性肠造口术后患者早期社会心理适应能力和自我护理能力,达到提升术后患者生活质量及降低并发症发生率的目的。     

农村自杀及自杀未遂与社会支持和生命质量的关系

目的:探讨社会支持和生命质量与农村地区自杀和自杀未遂的关系。方法:纳入国内4县的自杀死亡者151例、自杀未遂者118例及其中3县经分层随机抽样选取的健在居民140例。独立访谈知情人及健在案例本人,收集案例的人口学资料和精神科诊断,并使用社会支持量表和自编生命质量量表进行评估。结果:自杀组和未遂组符合精神障碍诊断的比例高于对照组(χ~2=133.66,P 0.001)。社会支持量表和生命质量量表的知情人评分在对照组中最高,自杀组低于未遂组(均P 0.001)。Logistic回归分析提示,在控制人口学变量后,精神障碍、生命质量、社会支持总分和支持利用度与自杀(OR=36.55、0.34、0.36、0.18,均P 0.05)或自杀未遂(OR=13.07、0.38、0.27、0.34,均P 0.05)相关。结论:增加社会支持的利用度及提高生命质量可能是预防农村自杀和自杀未遂的重要措施。     

赋能教育在肺结核患者中的应用及对情绪障碍、心理韧性的影响

目的:探讨赋能教育在肺结核患者中的应用效果及对情绪障碍、心理韧性的影响。方法:将2017年1月-2018年1月收治的260例肺结核患者采用随机数表法分为观察组和对照组,每组各130例。两组均应用常规健康宣教等干预,观察组在此基础上增加赋能教育。干预前、干预3月后,评估两组疾病认知水平、情绪障碍[抑郁自评量表(SDS)、焦虑自评量表(SAS)、结核病相关病耻感量表]、心理韧性[心理弹性量表(CD-RISC)]、自我管理[自我照护能力量表(ESCA)]。结果:①干预前,两组疾病认知调查表得分对比差异无统计学意义(P0.05);干预3个月后,两组疾病认知调查表得分均高于干预前,观察组增幅大于对照组(t=12.479,P0.05);②干预前,两组SDS、SAS、结核病相关病耻感量表得分对比差异均无统计学意义(P0.05);干预3个月后,两组SDS、SAS、结核病相关病耻感量表得分均低于干预前,观察组降幅大于对照组(t=-3.224,-6.875,-9.970;P0.05);③干预前,两组CD-RISC中坚韧、力量、乐观维度得分对比差异均无统计学意义(P0.05);干预3个月后,两组CD-RISC中坚韧、力量、乐观维度得分均高于干预前,观察组增幅大于对照组(t=14.416,10.339,8.134;P0.05);④干预前,两组ESCA量表技能、责任感、自我概念、健康知识得分均无统计学意义(P0.05);干预3个月后,两组ESCA量表技能、责任感、自我概念、健康知识得分均高于干预前,观察组增幅大于对照组(t=15.025,18.597,14.642,25.088;P0.05)。结论:赋能教育应用于肺结核患者效果良好,有利于改善患者疾病认知程度、情绪障碍、心理韧性和自我干预能力。     

住院抑郁症患者与精神分裂症患者自杀行为的分析

目的比较住院抑郁症患者与精神分裂症患者自杀行为的发生率、临床特征及自杀死亡率的差异。方法采用病史资料,精神检查和量表评定的方法 ,确定抑郁症32例,精神分裂症62例为研究对象,并在出院5年后追踪调查其自杀的情况。结果住院患者抑郁发作的自杀率为80.0%,自杀未遂为52.5%,精神分裂症自杀行为的发生率为32.4%,其中自杀未遂为21.9%,两类疾病自杀行为的人数所占百分比经卡方检验,差异显著(χ2=9.594,P0.01)。抑郁症自杀行为的影响因素以抑郁情绪为主(100%),绝望是自杀的直接原因,妄想(56.2%)、焦虑(25.0%)等次之;精神分裂症患者自杀的主要因素为幻觉妄想(59.7%),抑郁情绪(26.6%)次之。抑郁症与精神分裂症伴有自杀行为的患者5年追踪结果显示:两类患者都有自杀死亡行为,抑郁症的自杀死亡率高于精神分裂症(11.1%和8.8%)。结论抑郁症和精神分裂症的自杀需要长期的药物及心理干预。     

协同干预模式改善急性缺血性脑卒中患者负性情绪、自我感受负担和生存质量的效果

目的:观察协同干预模式(CCM)在改善急性缺血性脑卒中(AIS)患者负性情绪、自我感受负担与生活质量中的效果。方法:将医院2016年12月至2018年12月年收治的86例AIS患者纳为研究对象,随机将其分为观察组(n=43)与对照组(n=43),观察两组干预后患者负性情绪、自我感受负担、日常生活能力及生活质量。结果:出院时,观察组患者SAS量表得分显著低于对照组(t=-2.42,P0.05),两组SDS量表得分无显著性差异(P0.05),随访半年发现,观察组患者SAS及SDS量表得分均较出院时显著下降(t=10.85,13.77;P0.05),对照组SAS及SDS量表得分与出院时无显著差异(P0.05),且观察组出院半年后两量表得分均显著低于对照组(t=-7.94,-7.12;P0.05);出院时,两组患者身体负担、经济负担得分均无显著性差异(P0.05),观察组患者情感负担及SPBS量表总得分显著低于对照组(t=-3.24,-2.41;P0.05),随访半年发现,观察组患者身体、情感负担及SPBS量表总得分均较出院时显著下降(t=8.75,11.20,15.31;P0.05),经济负担显著上升(t=-3.57,P0.05),对照组身体、情感负担及SPBS量表总得分均较出院时显著下降(t=6.55,12.06,11.11;P0.05),经济负担显著上升(t=-2.89,P0.05),且观察组患者出院半年后,身体、情感及SPBS总得分均显著低于对照组(t=-3.67,-4.86,-5.88;P0.05);出院时,两组日常生活能力无显著性差异(P0.05),随访半年发现,观察组日常生活能力较出院时得以显著改善(P0.05),对照组日常生活能力与出院时无显著性改善(P0.05),且观察组出院半年后日常生活能力优于对照组,但组间差异不显著(P0.05);观察组患者主要照护者饮食(t=4.69,P0.05)、康复训练(t=5.48,P0.05)、心理干预(t=4.10,P0.05)、药物干预(t=3.91,P0.05)及疾病干预能力总得分(t=9.62,P0.05)均显著高于对照组;随访半年发现,观察组患者SF-36量表中身体功能、生理职能、躯体疼痛、总体健康、活力、社会健康、情感职能、精神健康及总得分均显著高于对照组(t=5.33,9.69,9.53,5.45,6.46,5.00,5.38,5.39,14.84;P0.05)。结论:CCM能有效提高AIS患者及其主要照护者疾病干预能力,改善患者负面情绪及自我感受负担,提高患者出院后生活质量。     

神经性厌食少年的情绪、冲动特点及与自伤自杀的关联

目的:探讨神经性厌食少年情绪、冲动的特点及自伤自杀危险因素。方法:采用儿童多维焦虑量表中文版、流调用抑郁自评量表、认知情绪调节问卷中文版、Barratt冲动量表中文版,对39名符合疾病和有关键康问题的国际统计分类第十次修订有神经性厌食诊断标准的少年,以及78名年龄、性别相匹配的正常对照进行评定,并对两组间评定结果进行比较。同时采用青少年健康相关危险行为问卷对病例组和正常对照组的自伤行为、自杀观念、自杀未遂进行评定和比较,并将人口学资料及上述各量表总分(青少年健康相关危险行为问卷总分除外)引入logistic回归模型,分析自伤行为、自杀观念、自杀未遂的危险因素。结果:病例组流调用抑郁自评量表分高于对照组(P0.05),认知情绪调节问卷中灾难化思维病例组得分高于对照组(P0.05)、反思自我得分病例组低于对照组(P0.05),而焦虑、认知情绪调节、冲动各项总分均无明显差异(均P0.05)。病例组自伤行为、自杀观念、自杀未遂评分高于对照组(均P0.05、0.002、0.001),存在自伤行为、自杀观念、自杀未遂的患儿比例分别为43.6%、41.0%、33.3%。Logistic回归分析未发现自伤行为的相关因素;冲动(OR=1.19,95%CI:1.04~1.37)与自杀观念相关联;且冲动(OR=1.15,95%CI:1.03~1.30)与自杀未遂相关联。结论:神经性厌食少年有明显较多的抑郁、灾难化思维、自伤行为、自杀观念及企图;冲动者更易出现自杀观念和自杀未遂。     

自杀风险评估的分层护理干预对住院抑郁症患者自杀行为的影响

目的:探讨基于自杀风险评估的分层护理干预对住院抑郁症患者自杀行为的影响。方法:选择2014年3月-2015年3月收治的抑郁症患者102例为研究对象,采用随机数字表法分为观察组和对照组各51例,对照组采用常规护理,观察组在对照组的基础上采用基于自杀风险评估的分层护理干预,随访6个月,比较两组自杀态度问卷(QSA)评分、自杀行为发生率。结果:观察组对自杀行为性质的认识、对自杀者的态度、对自杀者家属的态度、对安乐死的态度等得分均明显高于对照组(t=4.616~8.612,P0.05);有悲观厌世言行及服药、自缢、撞墙、割脉等自杀行为总发生率均明显低于对照组(χ2=7.141,5.132;P0.05)。结论:基于自杀风险评估的分层护理干预有助于减小住院抑郁症患者的自杀风险,降低自杀行为的发生率。     

心理危机干预在救治重度急性有机磷农药中毒患者中的应用

目的:研究心理危机干预在救治重度急性有机磷农药中毒(SAOPP)患者中的应用。方法:将我院2017年1月-2018年1月收治的150例SAOPP患者随机分为观察组(心理危机干预,n=75)与对照组(常规干预,n=75),观察两组抢救效果,入院7d后比较两组抑郁水平、应对技能、社会支持水平与护理满意度。结果:入院7d后,观察组、对照组胆碱酯酶(t=-46.76,-37.49;P0.05)、GCS得分(t=-19.01,-16.39;P0.05)均较入院时显著提高,血液毒液浓度(t=415.37,383.16;P0.05)较入院时显著降低,且观察组入院7d后,胆碱酯酶(t=3.96,P0.05)、GCS得分(t=4.84,P0.05)均显著高于对照组,血液毒液浓度(t=-7.40,P0.05)显著低于对照组;干预7d后,观察组抑郁情绪(t=-20.75,P0.05)、积极情绪(t=-9.47,P0.05)、躯体症状(t=-4.68,P0.05)、人际关系(t=-31.77,P0.05)及总得分(t=-21.67,P0.05)均显著低于对照组;干预7d后,观察组积极行动应对量表得分(t=12.26,P0.05)显著高于对照组,消极行为应对量表得分(t=-29.95,P0.05)显著低于对照组;干预7d后,观察组客观社会支持(t=9.25,P0.05)、主观社会支持(t=10.65,P0.05)、社会支持利用度(t=10.44,P0.05)及总得分(t=17.46,P0.05)均显著高于对照组;观察组服务满意度(t=13.71,P0.05)显著高于对照组。结论:心理危机干预可有效改善重度急性有机磷农药中毒患者抢救配合,提高救治效果,同时减轻其负面情绪、提高患者应对技能与社会支持水平。     

重度前列腺增生症患者不良情绪和社会支持及针对性干预效果

目的:分析重度前列腺增生症患者不良情绪和社会支持利用度,并观察采用心理干预对其不良情绪和社会支持利用度的影响。方法:选取2015年4月-2016年10月于我院就诊的重度前列腺增生症患者共90例,分为观察组和对照组各45例,两组患者均采用双极等离子汽化电切术,对观察组患者采用心理干预共3个月,对照组采用常规护理方式,采用前列腺评分量表(IPSS)分析患者前列腺症状,采用正负性情绪量表(PANAS)、社会支持评定量表(SSRS)分析两组患者采用心理干预前后的不良情绪和社会支持利用度变化。结果:两组患者治疗前的IPSS评分对比差异无统计学意义,经过3个月干预后观察组显著低于对照组,差异具有统计学意义(t=-5.787,P0.01),观察组患者在干预后的正性情绪评分显著上升(t=3.523,P=0.001),而负性情绪在干预后显著下降(t=-3.654,P0.01),其中干预后观察组的正性情绪评分显著高于对照组(t=2.178,P=0.032),且干预后观察组的负性情绪评分显著低于对照组(t=-3.345,P=0.001),两组患者治疗前的客观支持、主观支持、支持利用度和总分对比差异均无统计学意义,干预后观察组的客观支持、主观支持、支持利用度和总分评分均显著高于对照组(t=2.616,2.735,2.524,2.611;P0.05)。结论:对重度前列腺增生症患者采用针对性心理干预护理能够促进患者术后的前列腺症状缓解,增加患者的正性情绪和减少患者的负性情绪,显著提高了患者的社会支持利用度。     

Symptom components of standard depression scales and past suicidal behavior

BACKGROUND: Global severity on depression scales may obscure associations between specific symptoms and suicidal behavior. METHODS: We studied 298 persons with major depressive disorder. Factor analysis of the 24-item Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) was used to compare symptom clusters between past suicide attempters and non-attempters. RESULTS: Factor analyses extracted five HDRS and three BDI factors. Suicide attempters had significantly lower scores on an HDRS anxiety factor and higher scores on a BDI self-blame factor. The factor scores correlated with total number of suicide attempts and with known risk factors for suicidal behavior. LIMITATIONS: The differences in factor scores between suicide attempters and non-attempters were significant but modest and may be most relevant in suggesting areas for further clinical studies. Structured diagnostic interviews in this study may have limited the detection of Bipolar II or milder bipolar spectrum disorders. CONCLUSIONS: Depressed suicide attempters exhibit comparably severe mood and neuro-vegetative symptoms, but less anxiety and more intense self-blame than non-attempters. This clinical profile may help guide studies of biological correlates and of treatments to reduce suicide risk.     

Clinical evolution after self-induced or accidental traumatism: a controlled study of the extent and the specificity of suicidal catharsis

BACKGROUND: The cathartic effect has been related to the short-term decrease of depressive symptomatology following the suicide attempt. This study aimed to clarify the extent of this clinical improvement to non self-induced traumas and other suicidal dimensions. METHODS: Twenty-six recent suicide attempters were compared with 21 control subjects admitted to the surgical ward after an accident-induced trauma. They completed several assessments the day after the admission and one week after discharge: Hamilton and Carroll Depression scales, Barratt Impulsivity Scale, Hopelessness scale, State-Trait Anxiety Inventory, MMPI (abbreviated version), Global Assessment Scale. RESULTS: Depression, anxiety-state, two sub-scales of the MMPI (Hysteria, Depression) and general functioning improved significantly in the suicide attempters group. Measures of impulsivity and hopelessness remained stable during the follow-up. LIMITATIONS: These results cannot not be generalized to all suicide attempters and we did not take account of the lethality and severity of the suicidal method used. CONCLUSION: Our study supports the specific role of deliberate self-aggression in the cathartic effect and the trait value of both impulsivity and hopelessness.     

HPT axis, CSF monoamine metabolites, suicide intent and depression severity in male suicide attempters

A lower thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH) in depressed women has been associated with violent suicide attempts, suicidal intent, higher lethality and suicide risk. The cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) levels are related to suicidal behaviour. We studied the HPT axis function in twelve male suicide attempters and eight healthy volunteers submitted to lumbar puncture and to TRH test. Suicidal behaviour and depression severity were assessed. There was no association between deltamaxTSH and violent suicidality or subsequent suicide. The deltamaxTSH correlated with CSF HVA in suicide attempters. The plasma T3 showed a negative correlation with the Beck Suicide Intent Scale and the Montgomery Asberg Depression rating scale. Dopaminergic regulatory mechanisms on the thyroid hormone activity may be altered in male suicide attempters.     

Higher prevalence of depressive symptoms in middle-aged men with low serum cholesterol levels

OBJECTIVE: Investigators from several studies have reported a positive relationship between low cholesterol levels and death due to violent causes (eg, suicide and accidents), possibly mediated by depressive symptoms, aggression or hostility, or impulsivity. We set out to establish whether middle-aged men with chronically low cholesterol levels (< or =4.5 mmol/liter) have a higher risk of having depressive symptoms, according to scores on the Beck Depression Inventory, compared with a reference group of men with cholesterol levels between 6 and 7 mmol/liter. A similar comparison was also made for measures of anger, hostility, and impulsivity. METHODS: Cholesterol measurements were obtained as part of a population-based cholesterol screening study in 1990-1991. These levels were remeasured in 1993-1994. Only those whose cholesterol level remained in the same range were included in the study. Depressive symptoms were assessed by using the Beck Depression Inventory; anger, by questionnaires based on the Spielberger Anger Expression Scale and State-Trait Anger Scale; hostility, by the Buss-Durkee Hostility Inventory; and impulsivity, by the Eysenck and Eysenck Impulsivity Questionnaire. RESULTS: Men with chronically low cholesterol levels showed a consistently higher risk of having depressive symptoms (Beck Depression Inventory score > or =15 or > or =17) than the reference group, even after adjusting for age, energy intake, alcohol use, and presence of chronic diseases. No differences in anger, hostility, and impulsivity were observed between the two groups. CONCLUSIONS: Men with a lower cholesterol level (< or =4.5 mmol/liter) have a higher prevalence of depressive symptoms than those with a cholesterol level between 6 and 7 mmol/liter. These data may be important in the ongoing debate on the putative association between low cholesterol levels and violent death.     

Tachykinin receptor 1 variants associated with aggression in suicidal behavior.

Substance P is involved in the modulation of depression, anxiety, and suicidal-related behaviors. We studied gene variants of Tachykinin Receptor 1 (TACR1-rs3771810, rs3771825, rs726506, rs1477157) in 167 German suicide attempters (affective spectrum n = 107, schizophrenia spectrum n = 35, borderline personality disorder n = 25), 92 Caucasian individuals who committed suicide and 312 German healthy subjects. Single markers and haplotype analysis in relation to suicidal behaviors (suicide attempters/completers) did not reveal any significant association. The rarest rs3771825 T allele however showed a marginal association with higher Reactive Aggression scores on the Questionnaire for Measuring Factors of Aggression (FAF) (F = 9.86, df = 1; P = 0.0017). Haplotype analyses confirmed the finding. Violence or impulsivity of suicide attempt and State-Trait Anger Expression Inventory (STAXI) scores were not associated with gene variants. In conclusion, our study suggests that TACR1 gene variants have no major influence on suicidal behavior but may modulate aggression features.     

Clinical predictors of eventual suicide: a 5- to 10-year prospective study of suicide attempters

The Beck Depression Inventory, Hopelessness scale, and Suicidal Intent scale (SIS) scores of 413 patients, who were hospitalized for suicide attempts (attempters) between 1970 and 1975 and followed until 1982, were used in multiple logistic regression analyses to predict the risk of eventually committing suicide. Out of 10 clinical and demographic characteristics chosen to control for possible confounding with the scales, only a diagnosis of alcoholism predicted eventual suicide. The risk of the alcoholics eventually committing suicide was over five times greater than that of the non-alcoholics. Controlling for confounding with unemployment and a diagnosis of alcoholism, the SIS Precautions subscale was also found to predict eventual suicide. The risk of committing suicide rose 67% with each point that the Precautions scale increased. The 20 (4.8%) attempters who eventually killed themselves had described taking more precautions against discovery at the time of their index attempt than the 393 (95.2%) who did not commit suicide.     

北京某综合大学一年级学生自杀意念影响因素分析

目的: 调查大学生自杀意念的风险因素,探讨干预策略.方法: 采用整群抽样法,对北京某综合大学9个院系的所有一年级学生进行现况调查,使用Beck抑郁问卷、Beck焦虑问卷、Beck无望问卷、青年健康危害行为问卷(YRBS)、人格障碍诊断问卷-4(PDQ-4)和自编的一般情况问卷调查大学生自杀意念及相关心理行为问题.采用多因素logistic回归分析对一学年内自杀意念和一周内自杀意念的影响因素进行分析.结果: 共2055人填写了问卷,一学年内自杀意念的报告率8.1%,危险因素按OR值大小排列依次为有物质滥用(OR=4.37,95%CI:2.27-8.41)、一学年内有过明显抑郁情绪(OR=3.21,95%CI:2.20-4.68)、一学年内使用过远程求助(OR=1.78,95%CI:1.13-2.81)、一周内存在明显抑郁情绪(OR=2.14,95%CI:1.36-3.37)、分裂样人格因子分(OR=1.21,95%CI:1.07-1.37)、边缘人格因子分(OR=1.23,95%CI:1.09-1.38);一周内自杀意念的报告率5.5%,危险因素按OR值大小排列依次为一周内存在明显抑郁情绪(OR=4.62,95%CI:2.86-7.46)、阳性精神障碍家族史(OR=2.96,95%CI:1.34-6.56)、一学年内有过明显的抑郁情绪(OR=2.35,95%CI:1.49-3.69)、女性(OR=1.65,95%CI:1.09-2.52)、边缘人格因子分(OR=1.50,95%CI:1.30-1.72)、分裂型人格因子分(OR=1.17,95%CI:1.03-1.34).文科专业显示为一学年内自杀意念的保护因素(OR=0.63,95%CI:0.41-0.95).大一学生一学年内寻求精神卫生服务的比例占12.5%,9.8%使用远程求助方式.在使用当面求助方式上女性多于男性(4.8%/2.9%,x2=4.42,P:0.035);报告有自杀意念者一学年内总体求助、当面求助、远程求助比例均高于无自杀意念者(22.5%/11.3%、7.4%/3.2%、18.2%/8.9%,x2=23.0、10.3、19.7,P＜0.01).结论: 大学生自杀风险的筛查指标除自杀意念外还应考虑纳入抑郁、物质滥用、人格特点、阳性精神障碍家族史.大学生精神卫生服务宜从鼓励求助行为、主动提供延伸式服务、大力发展网络精神卫生服务三方面人手,提高服务质量.     

Classification of suicidal and nonsuicidal outpatients: A cluster-analytic approach

The revised Beck Depression Inventory (BDI), Hopelessness Scale (BHS), Anxiety Inventory (BAI), and Scale for Suicide Ideation (SSI) were administered to 1,172 outpatients diagnosed with mixed psychiatric disorders. The SSI then was used to classify the patients into 127 (10.8%) suicide ideators and 1,045 (89.2%) nonideators. Both agglomerative-hierarchical and nonhierarchical cluster analyses then were employed to identify three types of nonideators, who represented anxious depressed, hopeless depressed, and below-average overall symptomatology, and four types of ideators, who reflected hopeless, anxious depressed, severely suicidal, and below-average overall symptomatology. Implications of these classification systems for describing psychopathology were discussed.     

Irrational thinking and negative emotionality in college students and applicants for mental health services

Although Rational-Emotive Therapy (RET) would posit that greater levels of irrationality and negative emotionality will be found in distressed persons, this basic hypothesis has never been examined. In this study, 60 normal university students and 45 new client applicants for mental health services completed the Survey of Personal Beliefs to assess irrational ideation and the Beck Depression Inventory, the State-Trait Anxiety Inventory, the State-Trait Anger Inventory, the Problematic Situations Questionnaire, and the Profile of Mood States to assess negative emotionality. As predicted, the clinical group was found to be more anxious (p less than .01), more depressed (p less than .01), more confused (p less than .01), less vigorous (p less than .05), and to report lower frustration tolerance (p less than .05) as compared to the normal group. Overall, clinical subjects did not show higher levels of irrational thinking. However, clinical subjects with high depression scores had significantly higher overall irrational ideation in contrast to those in the normal group with low depression scores (p less than .05). Finally, significant correlations were found between overall irrational ideation and Trait Anger (p less than .01) and between overall irrational ideation and Total Guilt (p less than .05). Because the clinical group was significantly older by 10 years, replication with a larger number of subjects of equal ages is recommended.     

Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation

This paper evaluated long-term associations between psychosocial factors and premature mortality among women with suspected coronary artery disease (CAD). We tracked total mortality events over a median 9.3 years in a cohort of 517 women [baseline mean age = 58.3 (11.4) years]. Baseline evaluations included coronary angiography, psychosocial testing, and CAD risk factors. Measures included the Spielberger Trait Anxiety Scale, Beck Depression Inventory, self-rated health, and Social Network Index. Cox regression analysis was used to assess relationships. Covariates included age, CAD risk factors, and CAD severity. BDI scores (HR 1.09, 95 % CI 1.02–1.15), STAI scores (HR .86, 95 % CI .78–.93), and very good self-rated health (relative to the poor self-rated health group; HR .33, 95 % CI .12–.96) each independently predicted time to mortality outcomes in the combined model. SNI scores (HR .91, 95 % CI .81–1.06) and other self-rated health categories (i.e., fair, good, and excellent categories) were not significant mortality predictors after adjusting for other psychosocial factors. These results reinforce and extend prior psychosocial research in CAD populations.