Gender and risk factors for suicide: Evidence for heterogeneity in predisposing mechanisms in a psychological autopsy study
Gender and risk factors for suicide: Evidence for heterogeneity in predisposing mechanisms in a psychological autopsy study
复制标题
DOI：
10.4088/jcp.v67n1018
复制
发表时间：
2006-10-01
影响因子：
5.3
通讯作者：
Turecki, Gustavo
中科院分区：
文献类型：
--
作者：
McGirr, Alexander;Seguin, Monique;Turecki, Gustavo
目的：目前尚不清楚主要存在于男性中的临床和行为自杀风险因素是否可以扩展到女性。因此，我们探讨了自杀完成者在精神病理和人格变异方面的性别差异。方法：采用心理解剖方法，我们比较了一个大型城市社区351名连续自杀者的人格变异和精神病理学患病率与性别的关系。采用《DSM-IV- tr I轴障碍结构化临床访谈》和《DSM-IV II轴人格障碍结构化临床访谈》进行精神病学诊断，并对冲动攻击、气质和性格进行测量。随后，我们对男性和女性自杀者进行了二次分析，在年龄、当前抑郁状况和一生抑郁发作次数方面，男性和女性自杀者的比例为2:1。这项研究是从2000年底到2005年进行的。结果：女性不太可能符合当前和终生酒精滥用的标准，但那些符合标准的人比男性更不容易并发抑郁症。平均而言，女性较少冲动，但男性和女性高度冲动的比例相似，而冲动与酒精滥用有关，无论性别如何。女性更有可能符合终身焦虑症的标准；这些与非暴力自杀方式有关，与性别无关。结论：尽管在女性中患病率较低，但高水平的冲动和酗酒似乎对两性都是有效的危险因素。研究人员应该把重点放在女性身上，以确定其他自杀中介。
Objective: It is unclear whether clinical and behavioral suicide risk factors, identified primarily among men, can be extended to women. We therefore explored sex differences in psychopathology and personality variants among suicide completers.Method: Using the psychological autopsy method, we compared personality variants and the prevalence of psychopathology as a function of sex among 351 consecutive suicides in a large, urban community. Psychiatric diagnoses were obtained using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders, and measures of impulsive aggression, temperament, and character were administered. Subsequently, we carried out secondary analyses between male and female suicides matched 2:1 for age, current depression, and number of lifetime depressive episodes. The study was conducted from late 2000 to 2005.Results: Females were less likely to meet criteria for current and lifetime alcohol abuse, but those who did were less likely than males to have concurrent depression. On average, females were less impulsive, yet similar proportions of males and females were highly impulsive and impulsivity was associated with alcohol abuse irrespective of gender. Females were more likely to meet criteria for lifetime anxiety disorders; these were associated with nonviolent suicide methods, irrespective of gender.Conclusions: Despite a lower prevalence among females, high levels of impulsivity and alcohol abuse appear to be valid risk factors for both sexes. Researchers should focus on females for the identification of other suicide mediators.