初次自殺企圖者與重複自殺企圖者流行病學特徵之比較

Comparison of Epidemiological Characteristics between First-ever and Repeated Suicide Attempters

邱震寰(Chen-Huan Chiu) ； 郭千哲(Chian-Jue Kuo) ； 陳映燁(Ying-Yeh Chen) ； 陳喬琪(Chiao-Chicy Chen) ； 李明濱(Ming-Been Lee) ； 林俊宏(Chun-Hung Lin) ； 黃蒂(Dy Huang) ； 林純綺(Chun-Chi Lin)

《北市醫學雜誌》 3卷10期 (2006/10) Pp. 1000-1007

https://doi.org/10.6200/TCMJ.2006.3.10.06

摘要

目的：自殺企圖者為自殺之高危險族群，其最終自殺完成之機率遠高於一般人口。高比例的重複自殺為其高自殺完成的重要原因。因此，對重複自殺的個案加以探討，有其必要性。本文嘗試對此主題作一初步研究。方法：本研究對象為臺北市自民國九十二年九月二十六日至民國九十四年六月二十日止，由各單位通報至臺北市自殺防治研究發展中心之自殺企圖者共4102人，其中初次自殺企圖者有3431人(83.6%)，重複自殺企圖者則為671人(16.4%)。研究以電話訪談方式進行，除自殺事件相關資料外，並以簡式身心症狀量表(Brief Symptom Rating Scale, BSRS-5)評估個案身心狀態，所得資料以描述性流行病學對初次自殺企圖個案與重複自殺企圖個案兩群組進行分析比較。結果：實際進行完整訪談之個案，共有1623人，其中初次自殺企圖者有1109人(68.3%)，重複自殺企圖者則為514人(31.7%)。無論就所有個案或是訪談完成之個案，在性別分布上，重複自殺者女性比例均較高；而年齡層的分布，就所有個案來分析，並無統計上之差異，但若僅就訪談完成之個案來分析，重複自殺企圖者則有較年輕之趨勢。在自殺立即原因的分析上，重複自殺企圖者呈現較高的精神科方面問題(42.7% vs. 22.9%)。就精神科的病史上，重複自殺企圖者有74.8%曾在精神科就診，初次自殺企圖者則為43.2%。就診斷而言，兩者皆以憂鬱相關疾患為最主要問題。在BSRS-5的分析上，重複自殺企圖者在失眠，焦慮，敵意，憂鬱以及自卑等五個面向均呈現較高之得分。以總分加以分類，大於等於六分者，初次自殺企圖個案為363人(32.7%)，重複自殺企圖個案為322人(62.6%)，顯示重複自殺企圖者於訪談當時仍處於較不穩定之身心狀態。BSRS-5得分方面，男女並無差異。在控制其他變項之後，女性、BSRS得分大於等於6分、有精神科診斷及年齡較輕與重複自殺企圖有顯著的相關。結論：研究結果顯示，重複自殺企圖個案有較明顯之精神科方面問題，為自殺防治的重要目標族群，應該投注更多處理與治療。

關鍵字

自殺企圖 ； 簡式身心症狀量表BSRS-5 ； 重複自殺

並列摘要

Background and Purpose: The Aim of this study was to investigate the differences between those who attempted suicide for the first time (first-evers) and those who had a previous attempt (repeaters). Methods: The study population consisted of every person whose suicide attempt was reported to the Taipei Suicide- Prevention Research Center by the emergency services of the Taipei City hospitals between September 26,2003 and June 20, 2005 (n=4102). Telephone interviews were attempted each person. The Brief Symptoms Rating Scale (BSRS-5) was utilized to evaluate cases' current psychological distress. Cases are defined as repeaters if previous suicidal attempts were detected by interview or more than one registrations were noted in our database. The others are defined as first-evers. Results: Of the 4102 people in the total study population，3431 (83.6%) were first-evers and 671 (16.4%) were repeaters. 1623 cases completed the telephone interviews (first-evers: 1109, 68.3%; repeaters: 514, 31.7%). Female revealed higher repetition rate than male. Repeaters revealed a tendency of younger age. Psychiatric related problems was a major precipitating factors contributing suicidal attempts in repeaters (42.9% vs. 22.9%). 74.8% repeaters and 43.2% first-evers had previous psychiatric history. Depression-related disorders were the main psychiatric diagnosis among cases. In all aspects in BSRS-5, including insomnia, anxiety, hostility, depression and inferiority, the repeaters revealed higher scores than first-evers. A total BSRS-5 score of six or higher was obtained in 62.6% (n=322) repeaters and 32.7% (n=363) first-evers, which showed the repeaters were under higher current psychiatric distress. Logistic regression analysis revealed that female, BSRS scores greater or equal to 6, previous psychiatric history and lower age were highly correlated with repeated suicide. Conclusion: The results of this study demonstrate that repeaters had obviously more psychiatric related problems than first-ever. More attention should be paid for their further psychiatric intervention and treatment.

並列關鍵字

suicide attempt ； BSRS-5 ； repetition