Risk factors for suicide in China: a national case-control psychological autopsy study
Risk factors for suicide in China: a national case-control psychological autopsy study
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DOI：
10.1016/s0140-6736(02)11681-3
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发表时间：
2002-11-30
期刊：
影响因子：
168.9
通讯作者：
Zhou, MG
中科院分区：
文献类型：
--
作者：
Phillips, MR;Yang, GH;Zhou, MG
自杀是中国第五大死因，但自杀率高和自杀特征独特的原因尚不清楚。然后对519名自杀者和536名死于其他伤害的人的家庭成员和亲密关系进行了全面采访（对照）随机选择23个地理代表性的网站在China.Findings调整后的性别，年龄，居住地，和研究地点，8个显着的预测自杀仍然在最终的非条件Logistic回归模型。按重要性顺序，他们是：高抑郁症状评分，以前的自杀企图，死亡时的急性压力，低生活质量，高慢性压力，严重的人际冲突，在死亡前2天，与以前的自杀行为的血亲，和朋友或与以前的自杀行为。自杀风险随着暴露于多种风险因素而大幅增加：265名暴露于八种风险因素中的一种或更少风险因素的死者中，没有一人死于自杀，但30%（90/299）有两到三种风险因素，85%（320/377）有四到五种风险因素，96%（109/114）有6个或6个以上危险因素者死于自杀。解释尽管中国和西方自杀者的特征有很大差异，但自杀的危险因素并没有很大差异。专注于单一风险因素的自杀预防计划不太可能大幅降低自杀率;预防工作应侧重于暴露于多种风险因素的个人。
Background Suicide is the fifth most important cause of death in China, but the reasons for the high rate and unique pattern of characteristics of those who kill themselves are unknown.Methods We pretested, and then administered a comprehensive interview to family members and close associates of 519 people who committed suicide and of 536 people who died from other injuries (controls) randomly selected from 23 geographically representative sites in China.Findings After adjustment for sex, age, location of residence, and research site, eight significant predictors of suicide remained in the final unconditional logistic regression model. In order of importance they were: high depression symptom score, previous suicide attempt, acute stress at time of death, low quality of life, high chronic stress, severe interpersonal conflict in the 2 days before death, a blood relative with previous suicidal behaviour, and a friend or associate with previous suicidal behaviour. Suicide risk increased substantially with exposure to multiple risk factors: none of the 265 deceased people who were exposed to one or fewer of the eight risk factors died by suicide, but 30% (90/299) with two or three risk factors, 85% (320/377) with four or five risk factors, and 96% (109/114) with six or more risk factors died by suicide.Interpretation Despite substantial differences between characteristics of people who commit suicide in China and the west, risk factors for suicide do not differ greatly. Suicide prevention programmes that concentrate on a single risk factor are unlikely to reduce suicide rates substantially; preventive efforts should focus on individuals exposed to multiple risk factors.