山东农村居民自杀意念的发生率及其危险因素研究

摘要

目的 了解农村居民自杀意念的发生率及其危险因素,为自杀干预提供依据.方法 采用包括一般健康状况问卷、冲动性和攻击性量表、社会支持量表、家庭亲密度与适应性量表等对山东滕州市东郭镇19个村≥15岁的5039例农村居民进行自杀意念及其相关因素的调查,以多因素logistic模型分析自杀意念的危险因素.结果 在农村居民中,9.33%(470/5039)在过去任何时候有过自杀意念(95%CI:8.52%～10.13%),5.39%(299/5039,95%CI:5.28%～6.59%)近1年有过自杀意念.近1年自杀意念的危险因素排列为:近1年慢性压力大(OR=5.61,95%CI:4.04～7.78),攻击性高(OR=2.54,95%CI:1.93～3.35),非现婚状态(OR=2.04,95%CI:1.52～2.76),生命质量低(OR=1.86,95%CI:1.40～2.48),女性(OR=1.76,95%CI:1.34～2.32),自我感觉经济状况差(OR=1.70,95%CI:1.29～2.25),认识的人中有自杀(OR=1.53,95%CI:1.17～1.99),家庭亲密度低(OR=1.38,95%CI:1.06～1.80).结论 农村居民自杀意念发生率处于较高水平.慢性压力大、攻击性高、非现婚状态是近1年自杀意念最主要的危险因素.应根据其危险因素制订有针对性的干预计划.%Objective To explore the prevalence and risk factors of suicide ideation among rural residents and to provide appropriate suicide intervention strategies. Methods A battery of questionnaires including General Health Questionnaire, Impulsivity and Aggression Scale. Social Support Scale. Family Cohesion and Adaptability Scale was administered to 5039 residents who were 15 years or older from 19 villages of Dongguo Town, Tengzhou City, Shandong Province to investigate the prevalence of suicide ideation and related factors. Then we used the logistic regression to explore the risk factors of suicide ideation. Results The life-time prevalence of suicide ideation and the one-year prevalence among rural residents were 9. 33％ ( 95％ CI: 8. 52％ ～ 10. 13％ ) and 5. 39％ ( 95％ CI:5. 28％ ～ 6. 59％ ) , respectively. The risk factors of the suicide ideation during past one year were in descending order of importance: high chronic stress ( OR = 5. 61 ， 95％CI was 4. 04 ～ 7. 78) , high aggressiveness ( OR = 2. 54 , 95％ CI:1. 93 ～3. 35 ) , not-being married ( OR = 2. 04 ， 95％ CI:1. 52 ～ 2. 76) , poor quality of life ( OR = 1. 86. 95％ CI: 1. 40 ～ 2. 48) , being female ( OR = 1. 76. 95％ CI: 1. 34 ～2. 32) , poor self-reported economic status ( OR = 1. 70 , 95 ％ CI : 1. 29～ 2. 25 ) , having acquaintance with suicidal behavior ( OR = 1. 53 . 95％ CI : 1. 17 ～ 1. 99 ) . and poor family cohesion ( OR = 1. 38 , 95％ CI: 1. 06 ～1. 80) . Conclusions The prevalence of suicide ideation among rural residents is relatively higher, and high chronic stress,high aggressiveness as well as not-being married are main risk factors of one-year suicide ideation. It is essential to develop intervention strategies targeted at the risk factors of suicide ideation.