社会心理干预对自杀未遂者的效果

目的:对自杀未遂者实施社会心理干预,促进自杀干预工作的开展。方法:采用方便取样的方法,将某农村地区综合医院急诊室救治的115例自杀未遂者纳入研究。采用WHO健康量表、情绪稳定性量表、BECK抑郁自评量表等对115例被试评估后,将其随机分为干预组(n=58)和对照组(n=57)。对干预组实施心理社会干预,包括在院时针对自杀预防的健康教育和出院后18个月内的7次入户随访干预,而对照组仅在住院时给予必要的情绪舒缓。出院后18个月时采用入组时的测查工具,加上生活质量量表、目前感觉状态自我评价量表、应付方式问卷、社会支持量表对两组再次进行评估并比较。结果:出院后18个月内,干预组中1例自杀未遂,对照组中4例出现自杀行为(自杀未遂2例,自杀死亡2例),两组间比较差异无统计学意义(P0.05)。出院后18个月时,干预组WHO健康量表得分增值高于对照组(P0.05),两组在Beck抑郁量表、情绪稳定性量表减少分值差异无统计学意义(P0.05)。干预组出院18个月时的自我感觉评价得分,应对方式量表中的解决问题得分,社会支持量表中的主观支持、客观支持、支持总分均高于对照组(均P0.05),而自责得分低于对照组(均P0.05)。结论:本研究提示对农村自杀未遂者实施社会心理干预能够一定程度上改善其精神心理活动状况,降低绝望感,从而降低再自杀行为发生风险。

Effectiveness of 18-month psychosocial intervention for suicide attempters

Objective: To evaluate the effectiveness of psychosocial intervention for suicide attempters.Methods: A total of 115 suicide attempters treated in emergency room of a rural general hospital were interviewed about mental illness,physical diseases,factors related suicide and assessed with the Scale of WHO Well-being,Beck Depression Inventory and Trait Anger Scale.The suicide attempters were then randomly assigned to intervention group(n=58) and control group(n=57).The intervention group got psychosocial intervention including education on suicide prevention at hospital and 6-time home visits during the following 18 months.The controls were treated as usual and only got debriefing at hospital.The intervention outcome evaluated was administered to the two groups of patients at 18-month follow-up visit with the prior assessment tools and others including the Scale of Quality of Life,Scale for mature coping strategies,and so on.Results: During the 18 months after discharged from the hospital,1 patient attempted suicide again and none completed suicide in the intervention group,and 4 patients had suicidal behaviors in the control group(2 attempted suicide again and 2 completed suicide).At the 18-month follow-up interview,the scores of Scale of WHO Well-being in the intervention group were increased more than that in the control group(P<0.05),and there were no significantly difference among the scores of Beck Depression Inventory and Trait Anger Scale between the two groups.The mean scores of subjective feelings in the intervention group were significantly higher than that in the control group.The scores of problem-solving and social support in the intervention group were all higher than that in the control group(Ps<0.05).Conclusion: It suggests that the psychosocial intervention may effectively improve the life quality,decrease their hopelessness,and therefore decrease the risk of repeated suicidal behavior in rural suicide attempters.