绍兴市大学生精神障碍患者自杀态度及相关因素

黄磊; 郑春美; 庞卢伟; 赵云飞; 蒋海潮

doi:10.16835/j.cnki.1000-9817.2023.05.019

绍兴市大学生精神障碍患者自杀态度及相关因素

doi: 10.16835/j.cnki.1000-9817.2023.05.019

浙江省绍兴市第七人民医院精神科，312000

详细信息

作者简介:
黄磊(1980-)，男，浙江绍兴人，大学本科，副主任医师，主要研究方向为精神障碍

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.2 R179
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-21
- 修回日期: 2023-01-03
- 网络出版日期: 2023-05-25
- 刊出日期: 2023-05-25

Suicide attitude and related factors of college students with mental disorders in Shaoxing City

Department of Psychiatry, the Seventh People's Hospital of Shaoxing, Shaoxing(312000), Zhejiang Province, China

摘要

摘要: 目的分析绍兴市大学生精神障碍患者自杀态度及影响因素，为改善大学生精神障碍患者的自杀态度提供依据。方法于2018年1月—2021年12月对绍兴市绍兴文理学院、绍兴越秀外国语学院1 100名大学生完成调查问卷，其中有110名既往被医疗机构确认为存有精神障碍，应用单因素分析及多因素Logistic回归分析大学生精神障碍患者自杀态度的主要相关因素。结果单因素分析显示，大学生精神障碍患者自杀态度(肯定、反对)与年龄、性别、来源地、自杀意念、是否可控制自杀想法、冲动型人格类型、问题解决方式有关，组间差异均有统计学意义(χ²/t值分别为9.01，15.05，5.90，5.86，6.47，4.92，13.48，P值均 < 0.05)。多因素Logistic回归分析结果显示，年龄、性别、来源地、自杀意念、是否可控制自杀想法、冲动型人格类型、问题解决方式为大学生精神障碍患者自杀态度的相关因素(OR值分别为3.13，3.06，2.89，3.22，3.25，3.13，3.16，P值均 < 0.05)。结论冲动型人格类型和问题解决方式可对大学生精神障碍患者自杀态度产生影响。选用针对性的治疗方案可为改善大学生精神障碍状况，促进病情恢复提供依据。
- 精神障碍 /
- 自杀 /
- 精神卫生 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the suicide attitude and influencing factors of college students with mental disorders in Shaoxing City, and to provide a basis for improving the attitude of college students with mentaldisorders towards suicide. Methods From January 2018 to December 2021, 1 100 college students, among which 110 were previously confirmed by medical institutions to have mental disorders, were selected from two schools in Shaoxing, including Shaoxing University and Yuexiu Foreign Languages College, to participate in a questionnaire survey. Univariate and multivariate Logistic regression analysis were used to identify the main factors affecting the suicide attitude of college students with mental disorders. Results Univariate analysis showed that the influence of different nature of college students with mental disorders on suicide attitude was related to age, gender, origin, suicide ideation, whether suicidal thoughts can be controlled, impulsive personality type, problem solving style, the differences were statistically significant (χ²/t=9.01, 15.05, 5.90, 5.86, 6.47, 4.92, 13.48, P < 0.05). Multivariate Logistic regression analysis showed that age, gender, origin, suicidal ideation, uncontrolled suicidal thoughts, impulsive personality type, problem solving style were the main factors influencing the suicidal attitude of college students with mental disorders (OR=3.13, 3.06, 2.89, 3.22, 3.25, 3.13, 3.16, P < 0.05). Conclusion The main influencing factors of suicide attitude of college students with mental disorders in Shaoxing City can be impulsive personality type and problem solving and other factors. The selection of targeted treatment plan can improve the mental disorder condition of college students and promote the recovery of the disease.
- Mental disorders /
- Suicide /
- Mental health /
- Regression analysis /
- Students
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表 1 不同组别大学生精神障碍患者自杀态度构成比较

Table 1. A single factor analysis of suicide attitudes in different groups of college students with mental disorders

组别	选项	人数	肯定态度者	反对态度者	χ²值	P值
性别	女	65	30(46.15)	35(53.85)	15.05	< 0.01
	男	45	5(11.11)	40(88.89)
年龄/岁	≤18	48	8(16.66)	40(83.33)	9.01	< 0.01
	＞18	62	27(43.55)	35(56.45)
来源地	农村	50	10(20.00)	40(80.00)	5.90	0.02
	城市	60	25(41.67)	35(58.33)
精神病症家族史	有	25	5(20.00)	20(80.00)	2.08	0.15
	无	85	30(35.29)	55(64.71)
民族	汉族	80	27(33.75)	53(66.25)	0.51	0.48
	其他少数民族	30	8(26.67)	22(73.33)
宗教信仰	有	20	9(45.00)	11(55.00)	1.96	0.16
	无	90	26(28.89)	64(71.11)
家庭类型	双亲	30	9(30.00)	21(70.00)	0.06	0.80
	单亲	80	26(32.50)	54(67.50)
精神障碍类型	抑郁障碍	77	27(35.06)	50(64.94)	1.30	0.73
	精神分裂症	20	5(25.00)	15(75.00)
	双向情感障碍	8	2(25.00)	6(75.00)
	其他	5	1(20.00)	4(80.00)
自杀意念	未想过	25	3(12.00)	22(88.00)	5.86	0.02
	想过	85	32(37.65)	53(62.35)
是否可控制自杀	是	72	17(23.61)	55(76.39)	6.47	0.01
想法	否	38	18(47.37)	20(52.63)
冲动型人格类型	不冲动	81	21(25.93)	60(74.07)	4.92	0.03
	冲动	29	14(48.28)	15(51.72)
注：()内数字为构成比/%。

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表 2 大学生精神障碍患者自杀态度影响因素的多因素Logistic回归分析(n=1 100)

Table 2. Multivariate Logistic regression analysis of the influencing factors of suicidal attitude in patients with mental disorders among college students(n=1 100)

自变量	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
年龄	1.14	0.45	4.22	0.04	3.13(1.29~7.55)
性别	1.12	0.26	4.53	0.03	3.06(1.84~5.10)
来源地	1.06	0.30	4.52	0.03	2.89(1.60~5.20)
自杀意念	1.17	0.45	4.13	0.04	3.22(1.33~7.78)
是否可控制自杀想法	1.18	0.47	4.25	0.04	3.25(1.30~8.18)
冲动型人格类型	1.14	0.45	4.22	0.04	3.13(1.29~7.55)
问题解决方式	1.15	0.27	4.34	0.04	3.16(1.86~5.36)

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参考文献(25)

[1]	王若溪, 宋素怡, 周勇杰, 等. 严重精神障碍患者家庭照护者社会支持现状及影响因素分析[J]. 中国全科医学, 2022, 25(4): 480-488. doi: 10.12114/j.issn.1007-9572.2021.00.347 WANG R X, SONG S Y, ZHOU Y J, et al. Social support and its associated factors among family caregivers of persons with severe mentalillness[J]. Chin Gen Pract, 2022, 25(4): 480-488. (in Chinese) doi: 10.12114/j.issn.1007-9572.2021.00.347
[2]	MCKAY M T, CANNON M, CHAMBERS D, et al. Childhood trauma and adult mental disorder: a systematic review and Meta-analysis of longitudinal cohort studies[J]. Acta Psychiatr Scand, 2021, 143(3): 189-205. doi: 10.1111/acps.13268
[3]	NEWTON-HOWES G, AUSTIN S, FOULDS J. The prevalence of personality disorder in mental state disorder[J]. Curr Opin Psychiatry, 2022, 35(1): 45-52. doi: 10.1097/YCO.0000000000000761
[4]	张五芳, 马宁, 王勋, 等. 2020年全国严重精神障碍患者管理治疗现状分析[J]. 中华精神科杂志, 2022, 55(2): 122-128. doi: 10.3760/cma.j.cn113661-20210818-00252 ZHANG W F, MA N, WANG X, et al. Management and services for psychosis in the People's Republic of China in 2020[J]. Chin J Psychiatry, 2022, 55(2): 122-128. (in Chinese) doi: 10.3760/cma.j.cn113661-20210818-00252
[5]	冯为, 李世明, 杨雀屏, 等. 社区严重精神障碍患者规律面访情况及其影响因素研究[J]. 中国全科医学, 2022, 25(4): 475-479. doi: 10.12114/j.issn.1007-9572.2021.00.261 FENG W, LI S M, YANG Q P, et al. Prevalence and influencing factors of receiving regular interviews for patients with severe mental disorders in communities[J]. Chin Gen Pract, 2022, 25(4): 475-479. (in Chinese) doi: 10.12114/j.issn.1007-9572.2021.00.261
[6]	王存同, 韩婷婷, 张杰. 大学生自杀意念的外在保护因素分析[J]. 中国心理卫生杂志, 2022, 36(3): 243-247. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202203010.htm WANG C T, HAN T T, ZHANG J. External protective factors of suicidal ideation in college students[J]. Chin Ment Health J, 2022, 36(3): 243-247. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202203010.htm
[7]	易世, 郑年. 影响青少年自杀意念的因素: 抑郁和睡眠质量对青少年对心理健康服务态度的一系列中介作用[J]. 精神健康服务, 2020, 58(11): 29-36. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXXK202309002.htm YI S, ZHENG N. Factors influencing suicidal ideation in adolescents: depression and sleep quality a series of mediating effects of adolescents' attitudes towards mental health services[J]. J Ment Health Serv, 2020, 58(11): 29-36. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXXK202309002.htm
[8]	中华人民共和国卫生部卫生统计信息中心. 国际疾病分类(ICD-10)应用指导手册[M]. 北京: 中国协和医科大学出版社, 2001: 307-321. Health Statistics Information Center, Ministry of Health of the PRC. International Classification of Diseases(ICD-10) application instruction manual[M]. Beijing: Peking Union Medical College Press, 2001: 307-321. (in Chinese)
[9]	钱淑红, 张克峰, 段一鑫. 大学生非自杀性自我伤害与冲动性和抑郁症状的关系[J]. 中国心理卫生杂志, 2020, 34(11): 945-949. doi: 10.3969/j.issn.1000-6729.2020.11.010 QIAN S H, ZHANG K F, DUAN Y X. Relationship among non-suicidal self-injury, impulsivity and depressive symptoms in college students[J]. Chin Ment Health J, 2020, 34(11): 945-949. (in Chinese) doi: 10.3969/j.issn.1000-6729.2020.11.010
[10]	陈冲, 杨思, 崔梦侨. 问题解决问卷(PSI)中文版在大学生中使用的信效度研究[J]. 中国临床心理学杂志, 2010, 18(1): 26-27. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201001010.htm CHEN C, YANG S, CUI M Q. Realiabilty and Validity of the Chinese Version of Problem Solving Inventory (PSI) for Undergraduates[J]. Chin J Clin Psychol, 2010, 18(1): 26-27. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201001010.htm
[11]	史艳琴. 山西医科大学汾阳学院医学生自杀态度调查[J]. 职业与健康, 2020, 36(9): 1255-1258. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK202009027.htm SHI Y Q. Investigation on suicide attitude of medical students in Fenyang College of Shanxi Medical University[J]. Occup Health, 2020, 36(9): 1255-1258. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK202009027.htm
[12]	马凌悦, 陈松, 李安宁, 等. 我国精神障碍药物临床试验研发现状的调查分析[J]. 中国临床药理学杂志, 2022, 38(5): 460-464. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ202205014.htm MA L Y, CHEN S, LI A N, et al. Investigation and analysis of current situation of clinical trial development of psychotropic drugs in China[J]. Chin J Clin Pharmacol, 2022, 38(5): 460-464. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ202205014.htm
[13]	AFTAB A, RASHED M A. Mental disorder and social deviance[J]. Int Rev Psychiatry, 2021, 33(5): 478-485.
[14]	邵红敏, 徐改玲, 徐广明. 青少年精神障碍患者自杀行为研究进展[J]. 齐齐哈尔医学院学报, 2020, 41(12): 1525-1527. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB202012028.htm SHAO H M, XU G L, XU G M. The research advances of suicidal behaviors in adolescents with mental disorders[J]. J Qiqihar Univ Med, 2020, 41(12): 1525-1527. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB202012028.htm
[15]	黄少南, 张懿, 孔君, 等. 青少年精神障碍患者非自杀性自伤行为现状及影响因素分析[J]. 华南预防医学, 2021, 47(12): 1564-1567. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202112019.htm HUANG S N, ZHANG Y, KONG J, et al. Analysis of the current status and influencing factors of non-suicidal NSSI in adolescents with mental disorders[J]. South China J Prev Med, 2021, 47(12): 1564-1567. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202112019.htm
[16]	张萌, 李钰婷, 吕钦谕, 等. 精神疾病患者自杀与心理健康素养关系的研究进展[J]. 中国健康教育, 2020, 36(1): 71-74. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202001017.htm ZHANG M, LI Y T, LYU Q Y, et al. Advances in research on relationship between suicide and mental health literacy in patients with mental illness[J]. Chin J Health Educ, 2020, 36(1): 71-74. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202001017.htm
[17]	胡淑文, 钟慧, 莫大明, 等. 青少年抑郁障碍患者心理理论能力与自杀未遂的相关性研究[J]. 中华行为医学与脑科学杂志, 2022, 31(3): 241-247. HU S W, ZHONG H, MO D M, et al. Correlation between theory of mind and attempted suicide in adolescents with depressive disorder[J]. Chin J Behav Med Brain Sci, 2022, 31(3): 241-247. (in Chinese)
[18]	梁晓敏, 马亚荣, 孙彬, 等. 精神障碍住院患者短期内自杀未遂相关因素分析[J]. 中国神经精神疾病杂志, 2021, 47(1): 34-37. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSJJ202101007.htm LIANG X M, MA Y R, SUN B, et al. Related factors of short-term suicide attempt among hospitalized patients with mental disorders[J]. Chin J Nervous Ment Dis, 2021, 47(1): 34-37. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSJJ202101007.htm
[19]	高飞, 宋晓凡, 迟晓慧, 等. 济南市某大学学生生活目的感在社会支持与自杀态度间的中介作用[J]. 医学与社会, 2020, 33(1): 120-124. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSH202001031.htm GAO F, SONG X F, CHI X H, et al. The mediating effect of sense of purpose in life between social support and suicide attitude in a college of Jinan City[J]. Med Soc, 2020, 33(1): 120-124. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXSH202001031.htm
[20]	王红, 肖艳霞, 杜晶阁, 等. 抑郁发作患者自杀未遂的相关因素[J]. 中国心理卫生杂志, 2021, 35(7): 541-545. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202107004.htm WANG H, XIAO Y X, DU J G, et al. Risk factors of suicidal attempt in patients with depressive episode[J]. Chin Ment Health J, 2021, 35(7): 541-545. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202107004.htm
[21]	王超, 张艺琳, 邹广顺, 等. 686名医学生有无自杀意念调查及影响因素分析[J]. 山东大学学报(医学版), 2022, 60(1): 78-85. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202201012.htm WANG C, ZHANG Y L, ZOU G S, et al. Suicidal ideation and influencing factors in 686 medical students[J]. J Shandong Univ(Health Sci), 2022, 60(1): 78-85. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202201012.htm
[22]	金庞, 周波, 王国民, 等. 决策树模型及Logistic回归模型对精神分裂症患者自杀的影响因素分析[J]. 中国卫生统计, 2021, 38(3): 442-445. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT202103033.htm JIN P, ZHOU B, WANG G M, et al. Decision tree model and Logistic regression model for mental score analysis of influencing factors of suicide in schizophrenic patients[J]. Chin J Health Stat, 2021, 38(3): 442-445. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT202103033.htm
[23]	傅燕艳, 邹仪瑄, 杨丽霞, 等. 中学生应对方式与自杀相关行为的关系分析[J]. 现代预防医学, 2018, 45(20): 3760-3765. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201820029.htm FU Y Y, ZOU Y X, YANG L X, et al. Analysis of the relationship between coping style and suicidal behaviors in middle school students[J]. Mod Prev Med, 2018, 45(20): 3760-3765. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201820029.htm
[24]	陈君, 耿仁文. 心理健康与自杀行为的影响因素: 基于对三所高校10 340名医学生的调查[J]. 南方医科大学学报, 2020, 40(11): 1689-1692, 封3. https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD202011025.htm CHEN J, GENG R W. Factors affecting psychological health and suicidal behavior: based on a survey of 10340 medical students from three universities[J]. J Southern Med Univ, 2020, 40(11): 1689-1692, Seal 3. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD202011025.htm
[25]	陈慧, 潘冰, 张晨昀, 等. 应用于青少年精神障碍患者的非自杀性自伤行为量表修订[J]. 中南大学学报(医学版), 2022, 47(3): 301-308. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYD202203004.htm CHEN H, PAN B, ZHANG C Y, et al. Revision of the non-suicidal self-injury behavior scale for adolescents with mental disorder[J]. J Cent South Univ(Med Sci), 2022, 47(3): 301-308. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNYD202203004.htm