精神科急诊患者自杀自伤行为相关因素的调查分析

摘要

目的：对精神科急诊患者自伤自杀行为发生及相关因素进行初步调查。方法：采用自杀危险因素评估表对精神专科医院急诊非取药患者1325例进行评估，并根据评分将其分为自伤自杀组146例（评分≥21分）和非自伤自杀组1179例（评分≤20分），分别对两组社会人口学及疾病学资料进行调查分析。结果：女性就诊者自伤自杀行为高于男性（χ2=6.158，P <0.05），白天就诊者高于其他时间段就诊者（χ2=27.740，P <0.001），父母关系不和的就诊者高于父母关系好的就诊者（χ2=9.771， P <0.01），存在疾病诱因的就诊者高于无疾病诱因的就诊者（χ2=15.134，P <0.01），多次发病的就诊者高于首次发病的就诊者（χ2=8.578，P <0.05），临床诊断焦虑抑郁状态的就诊者高于其他临床诊断的就诊者（χ2=125.203，P <0.001）及有躯体疾病的就诊者高于无躯体疾病的就诊者（χ2=9.039，P <0.05）。结论：女性、发病诱因、发病次数、躯体疾病、父母关系、就诊时间及焦虑抑郁状态是精神科急诊患者发生自伤自杀行为的主要相关因素。%Objective:To investigate risk factors for self-injurious and suicidal behaviors of patients in psychiatric emergency. Method:A total of 1 325 outpatients in psychiatric emergency was enrolled. Patients were assessed using suicide risk factors checklist,and divided into self-jurious and suicidal group(146 cases) (score≥21)and non-suicidal group(1 179 cases)(score≤20)based on the assessment scores. The demo-graphic and disease related data were compared between the two groups. Results:Female patients showed higher rate on self-injurious and suicidal behaviorse than male patients(χ2 = 6. 158,P < 0. 05);higher rate on self-injurious and suicidal behaviors were found in the patients whose parents had non-harmonious relationships than those whose parents got along well(χ2 = 9. 771,P < 0. 01);patients who came to the emergency daytime had higher self-injurious and suicidal behaviors than came other time(χ2 = 27. 740,P < 0. 001);self-injurious and suicidal behaviors were higher in the patients who had induced factors than those who did not(χ2 = 15. 134, P < 0. 01);there were higher self-injurious and suicidal behaviors in relapse patients than first onset patients(χ2 =8. 578,P < 0. 05);the patients diagnosed as anxiety and depression had higher self-injurious and suicidal be-haviors than dagnosed as other disorders(χ2 = 125. 203,P < 0. 001);patients with medical conditions demon-strated higher self-injurious and suicidal behaviors than those without medical conditions(χ2 =9.039,P < 0.05). Conclusion:Self-injurious and suicidal behaviors occur more in patients who are female,diagnosed as anxiety and depression,with recurrent disorder and physical disease,have indeced factors and discord parental relations.