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Objective To explore the attribution of suicidal behavior which was judged by different respondents of suicide and suicide attempts.Methods Suicide attempts (120 cases) and suicide deaths (151 cases) were recruited.For each cases,a co-habitat family member and an associate (majority were neighbors) were interviewed independently.The attempter himself/herself was also interviewed.Every respondent reported the cause of the index suicide behavior,life events occurred one year prior to suicidal behavior,and depressive symptoms in one month prior to suicidal behavior.Results For suicide group,31.2％ of family member respondent attributed the index suicidal behavior to physical illness,15.6％ of them attributed it to family conflicts,and 7.8％ of them attributed it to depression.However,among associate respondents,24.8％,28.4％ and 13.5％ of them attributed the index suicidal behavior to physical illness,family conflicts,and depression.Family members were less likely attributed suicidal behavior to family conflict (x2=11.17,P ＜0.01),and associates were less likely attributed it to physical illness (Fisher's exact test,P＜0.01).In suicide attempt group,61.2％ of attempters themselves,60.5％ of family members and 69.2％ of associates attributed suicidal behavior to family conflict;10.3％ of attempters themselves,11.4％ of family members and 3.4％ of associates attributed it to physical illness.The associates were less likely attributed it to physical illness (Cochran Q=12.80,P＜0.01).Only 4.3％ of attempters,2.6％ of family members and 2.6％ of associates attributed index suicide behavior to depression.In the attempt group,29 attempters themselves,14 family members and 9 associates reported that the attempter had five or above depressive symptoms,but only 1 attempter himself,1 family member and none of associates attributed the attempt to depression.In suicide death group,45 family members and 49 associates reported the decedents had five or above depressive symptoms,but only 6 family member and l0 associates attributed index suicidal behaviors to depression.The respondents who attributed index suicidal behavior to family conflict reported a higher score of acute stress due to life events of family conflicts.Conclusion All respondents underestimate the effect of depression on suicidal behaviors.It is important to promote public health education on depression.Family conflict is one of the major precipitating factors of suicide behavior in China.
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Objective To compare the identifiability for depressive symptoms using different instruments while interviewing with different respondents in suicide prevention research in China. Methods One hundred and fifty-one suicide death cases (suicide group) and one hundred and twenty suicide attempt cases (attempt group) were recruited. For each identified cases, one family member proxy respondent, and another associate proxy respondent (friend or neighbor) and suicide attempter (only for attempt group) were interviewed separately by qualified psychiatrists. The Di-agnostic Screening Instrument for Depression (DSID) and the Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders (SCID-Ⅰ) were administered to each respondent to identify the depressive symptoms based on diagnostic criteria for major depressive episode in DSM-Ⅳ. Data collected from family members and associate respondents were merged as proxy data. The concordances of the DSID and SCID-Ⅰfor identifying depressive symptoms, meeting for criteria of Major Depressive Episode (MDE) and Mild and Major Depressive Episode (MMDE), were calculated based on different respondents' data. The prevalence of depressive symptoms, MDE and MMDE, were compared among merged proxy data, family member respondent's data, and associate respondent's data in suicide group and attempt group, and between self-respondent's data and merged proxy data in suicide attempt group. Results In suicide group, based on merged proxy data, the prevalence of MDE was 41.1%(62 cases) for DSID and 41.7%(63 cases) for SCID-Ⅰ, and the Kappa coeffi-cient was 0.77. Based on suicide attempters' self-raported data, the prevalence of MDE was 23.7% (27 cases) and 22.0% (24 cases) for DSID and SCID-Ⅰ respectively, with a Kappa of 0.74. Based on merged proxy report in attempt group, 16 (13.3%) and 15 (12.5%) cases were met for criteria of MDE (Kappa=0.89), using the 2 instruments. In both of the suicide and attempt groups, the merged proxy data got higher prevalence of depressive symptoms, MDE and MMDE than that only based on family respondent's data or associate's respondent's data using both of the 2 instruments (all P<0.05). Compared with merged proxy data, attempters' self-reported data got higher prevalence of MMD and MMDE using both of the 2 instruments (all P<0.05). Conclusions Based on same respondent's data, SCID-Ⅰ performs as well as DSID in identifying depressive symptoms. Collecting data from 2 respondents would get higher prevalence of MDE or MMDE than only from one family member or one associate. In attempt group, the prevalence of MDE or MMDE based on merged proxy data were lower than that based on attempters' self-reported data.
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Objective:To develop the Counseling Skills Rating Scale for Psychological Aids Hotline (CSRSPAH),an instrument to objectively assess the quality of process of counseling or intervention provided by hotline operators,and to test its validities and reliabilities.Methods:A draft of the scale,which consisted of 50 items under 5 dimensions,was designed in line with previous researches and the practice.In pilot study,supervisors at Beijing psychological aids hotline,assessed tape recorded sessions and gave feedbacks on the draft of the scale.The scale had been revised based on the pilot study.Twenty-eight items were deleted,and several items were rephrased.Finally,a scale which consisted of 22 items within 3 dimensions,i.e.counseling process,attitude,and communication skill,was developed.The scoring standards of the scale were also developed.To evaluate the IntraClass Coefficients (ICC) of the CSRSPAH,each of the tape records of 37 callings from 2005 to 2007 were assessed by 7 supervisors independently,using the scale.And the tape records of other 318 callings from 2013 to 2014 were also assessed by supervisors,using the CSRSPAH.The results of the 318 assessed callings were used to test the construct validities with the Confirmative Factor Analysis.The Cronbach a coefficients of the total score and three dimensions,the discriminant indices of every items,and correlations of each items and each dimensions were calculated,based on the 318 assessed callings.Results:One of the items (referral) was deleted due to excessive amount of missing data.Results of cortfirmative factor analysis of the remained 21-item scale revealed that the 3-factor construct structure of the scale was robust.The fitting indices of the confirm factor analysis were,x2/df=675.21/186,CFI =0.92,NNFI =0.91,RMSEA =0.10,SRMR =0.08.The Cronbach α coefficients of the total score,scores of counseling process,attitude,and communication skill,were 0.89,0.68,0.81 and 0.77,respectively.The ICCs of the inter-rater reliabilities of the total score and 3 dimensions of the scale were 0.67,0.59,0.59,and 0.67,respectively.The discriminant indices of all the 21 items ranged from 0.09 to 0.32.The correlation coefficients of scores of each items and scores of 3 dimensions and total scores were greater than 0.30,and reached statistical significance.Conclusion:The validities and reliabilities of the Counseling Skills Rating Scale for Psychological Aids Hotline are acceptable.The scale could be used in assessing the quality of hotline counseling or intervention,and related studies in the future.
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Objective To examine the different effects of impulsive and aggressive personality on college students' suicide attempt. Methods Four thousand nine hundred eighteen sophomores and juniors were selected according to the principle of cluster sampling from Beijing agricultural university and Beijing university of information science and tech?nology. Four thousand seven hundred ninety-seven of them completed the survey. Their impulsive and aggressive person?ality were evaluated by the Barratt Impulsiveness Scale-Chinese Versions (BIS-CV) and the Buss-Perry Aggression Questionnaire-Chinese Versions (AQ-CV). A self-made questionnaire were used to investigate suicidal idea and self-in?jury/suicidal behavior of college students. Results Among the sophomores and juniors, 18 participants had self-injury/suicidal behavior (3.75‰) and 1843 had suicidal idea (38.42%). Compared with the students who didn’t have self-inju?ry/suicidal behavior, those who once had self-injury/suicidal behavior had significantly higher BIS-CV score (P<0.01) and higher scores of non-planning and motor factors (P<0.05). They also had significantly higher score in AQ-CV and the factors of physical aggression, verbal aggression, anger, hostility and pointing to the self attacks (P<0.01). Conclu? sions The college students with self-injury/suicidal behavior have higher tendency in impulsive and aggressive personali?ty. Therefore, it is necessary to prevent suicide behavior, form high impulsive and aggressive intention and behavior.
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Objective:To understand the characteristics of the callers with the diagnosis of mental disorders called Beijing Psychological Crisis Hotline for help,in order to provide specific psychological intervention services for them in future.Methods:From December 2002 to December 2008,24217 different callers'data collected from a computer-based operating system of the Beijing Psychological Crisis Hotline were analyzed.According to their self-reported of having the diagnoses of mental disorder or not,the callers were divided into the ones with diagnosis (n=6516)and the ones without diagnosis (n =17701).The callers'demographic characteristics,their main counseling problems and the suicide-related factors in the two groups were compared.Results:The top five main counseling problems in the group with diagnosis were mental problems,the mental illness related knowledge,the problems of family relationships,working problems and interpersonal problems.Mental problem ranked first in both groups.Compared to the group without diagnosis,the diagnosed ones were more likely to be found in such group of people as women,aged between 20 -29 and 30 -44,having 10 or more years of education and the unem-ployed.The results of the assessments of 11 suicide-related risk factors showed that callers with diagnoses had higher prevalence of most suicide-related factors than those in the other group(P <0.001 or 0.05),which included suicidal intention and behavior while calling,history of attempted suicide,severe depressive symptoms,severe physi-cal illness,history of being abused,afraid of being attacked,suicidal history of relatives or associates,severe of hopeless.Conclusion:The hotline counselors should be aware of the necessity of assessing the severity of depres-sion and other suicide-related factors for the callers with mental disorder diagnoses before providing any psychologi-cal intervention.Moreover,except for providing interventions on the callers'psychiatric problems,the hotline coun-selors should also identify and help to deal with the stress events in their lives.
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Objective To Compare characteristics between the psychological aids hotline callers who had single attempted suicide and those callers who had repeated attempted suicide. Methods The analysis was conducted on the da?tabase of Beijing psychological aids hotline from Dec., 2002 to Dec., 2008. All the effective callers were consulted by pro?fessional hotline operators. During the calling, the callers were interviewed on their attempted suicides, depression and 11 correlates associated with caller's suicidal behaviors. Results Among 4519 callers who had attempted suicide, 2441 (54%) of them had attempted suicide once, and the other 2078 (46.0%) callers had repeated suicide attempts. After ad?justed for gender, age, and the other 4 demographic variables, history of being abused (OR=1.35, 95%CI: 1.08~1.67), afraid of being attack (OR=1.35, 95%CI: 1.01~1.59), relatives or associates with prior suicidal behavior history (OR=1.17, 95%CI: 1.001~1.36), hopelessness (OR=1.20, 95%CI: 1.02~1.40), and psychological treatment history (OR=0.73, 95%CI:0.62~0.86) were associated with repeated suicide among hotline callers. Conclusions To improve the effective?ness of hotline based suicide prevention, assessment of risk of repeated attempted suicide among the callers with a histo?ry of prior attempted suicide should focus on the history of being abused, afraid of being attack, hopelessness, relatives or associates with prior suicide history, and psychological treatment history.
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Objectives:To explore the prevalence and correlates of attempted suicide among Beijing psycho-logical aids hotline callers,in order to provide knowledge of hotline-based suicide prevention.Methods:From De-cember 2002 to December 2008,all the effective callers who consulted themselves'psychological problem,by Bei-jing psychological aids hotline were interviewed by professional hotline operators during the consulting calling.Data of whether callers attempted suicidal behavior in 2 weeks prior to the calling,gender and other 5 demographic char-acteristics of callers were collected via hotline interview.A questionnaire including depression screening scale,com-mon psychiatric symptoms such as delusion,hallucination,etc.,a history of substance abuse or dependence,a histo-ry of suicidal behavior,having had acute or chronic life events,and severity of hopeless was used during hotline in-terview.Logistic regression model was used.Results:In 22 415 interviewed callers,362 (1.6%)callers (233 fe-males)reported that they attempted suicidal behavior in 2 weeks prior to the calling.After adjusted for demographic characteristics,prior suicidal behavior 2 weeks before calling (OR=4.43,95%CI:3.37-5.83),hopelessness (OR=2.01,95%CI:1.52-2.67),substance abuse (OR=1.97,95%CI:1.48 -2.62),acute negative life events (OR=1.94,95%CI:1.49-2.52),and severe depressive symptoms (OR=1.45,95%CI:1.08-1.95)were associatedwith attempted suicide among hotline callers.Conclusion:The rates of attempted suicide among hotline callers are probably high.Suicide prevention in hotline would shed light on improving coping skills for life events and sub-stance abuse problems for hotline callers.
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Objective Describe the prevalence of depressive disorders (mood disorders with current depressive episode) among individuals treated in general hospitals in Beijing. Methods 2877 outpatients and 2925 inpatients ≥15 years of age from 50 general hospitals (selected by stratified random sampling) were screened by trained psychiatric nurses using a depression screening instrument and then the gold standard diagnosis of all subjects screened positive and 10% of those screened negative was determined by a trained psychiatrist who used a semi-structured interview schedule based on American psychiatric diagnostic criteria (DSM-IV). Results The adjusted point prevalence, one-year prevalence, and lifetime prevalence of any type of depressive disorder were 5.23%, 5.72% and 8.22%, respectively; corresponding prevalences of major depressive disorder were 2.94%, 3.46%, and 5.32%, respectively. Conclusions The prevalence of depressive disorders among patients in general hospitals in Beijing is not significantly higher than in the general population in China.
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Objective To investigate the prevalence, characteristics and correlates of depressive symptoms in first episode schizophrenic patients. Methods To examine 164 first episode schizophrenic patients at the time of admission and at 3,6,9, and 12 months after starting treatment using the HAMD, BPRS, the Chinese version of SANS, CGI and GAF. Results 71% of the patients had depressive symptoms (mild or more) at damission, but the prevalence of depressive symptoms dropped to a mean of 12% during the recovery period. The most prominent depressive symptoms during the acute phase of schizophrenia were ‘cognitive disturbance’ and ‘retardation’ (the respective subscales constituted 35% and 29% of the total HAMD score on admission). Depressive symptoms improved in parallel with the schizophrenic illness. The severity of depressive symptoms was not related to gender, age of onset, educational level, duration of prodromal period or duration of illness. At admission the severity of depressive symptoms was only related to the BPRS anxiety and depression subscale score, but during the recovery period the HAMD total score was significantly correlated with all of the other clinical scales. The level of depressive symptoms at admission and at three months after starting treatment was not related to the subsequent course of positive or negative symptoms. Conclusions Depressive symptoms appeared to be a separate symptom cluster during the acute phase of first episode schizophrenia. The severity of depressive symptoms did not predict the clinical outcome of first episode schizophrenic patients.
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Objective: Describe the depressive symptoms and suicidal characteristics of patients with major depressive episodes treated in non-psychiatric outpatient and inpatient departments of general hospitals. Methods: Trained psychiatric nurses administered our depression screening instrument to 2 877 consecutive outpatients and 2 925 inpatients who were at least 15 years of age, able to complete the survey and had no serious communication difficulties. These subjects were identified from 35 level-1, 8 level-2, and 7 level-3 general hospitals in Beijing that were selected by stratified random sampling. Results:Compared to 5 604 patients without depression, a higher proportion of the 198 patients with major depressive episode were agricultural laborers (14.2% v. 7.9%, ?2=17.48), uninsured (45.2% v. 37.8%, ?2=4.41), inpatients (63.1% v. 50.0%, ?2=13.26), treated in internal medicine departments (the internal medicine, surgical, genecological, traditional Chinese medicine and other medical departments distribution of depressed versus non-depressed patients was 51.5%, 30.8%, 3.0%, 2.5%, and 12.1% v. 40.7%, 30.5%, 9.8%, 4.9%, and 14.0%, ?2=17.28), less educated [9(4) v. 10(5) years of formal education, t=-3.55] and relatively poor (median monthly per capita income in the family was 500 yuan v. 800 yuan, Z=-4.86) (all P
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Objective:Compare the characteristics of male and female suicide attempters with the goal of explaining the significantly higher rates of suicide attempts in women.Method:Investigators who were rigorously trained in the research schedule assessed 326 serious suicide attempters (248 women and 78 men) treated in the emergency rooms of general hospitals and conducted an examination to determine the psychiatric diagnosis (based on DSM-IV criteria).Results:Most characteristics were similar in male and female attempters: age, family financial status and characteristics, number of prior suicide attempts, method used in the attempt, suicidal intent, number and psychological effect of negative life events, and rate of mental illness. The three most frequent negative life events were the same for men and women: marital conflict, major changes in daily routines, and financial difficulties. But compared to male attempters, female attempters had lower educational achievement, were more likely to be currently married, were more likely to have been working at the time of the attempt, had younger co-resident family members, had less contact with adult family members in the month before the attempt, and were less likely to have alcohol dependence (p's all