Prevalence Survey Of Mental Disorders And The Characteristics Analysis Of Suicide Attempters Of The Emergency Department In The General Hospitals

PrefaceIn China,Suicide due to mental disorder among all those who commit suicide is generally believed that the percentage be about between 20%and 30%,and the suicide rate of various types of mental disorders is 51/10 million which is 6-12 times than the general population.Mental disorders and suicidal behaviour are closely related,is the death of risk factors for suicide.In foreign country it is reported that the prevalence of mental disorders of attempted suicides is 80%-95%,but the domestic surveys of psychiatric diagnosis reported 32.5%-63%.Therefore,the recognition of the proportion of various mental disorders of domestic suicide attempters,and further understanding of the clinical features of suicide attempters with mental disorders,will help us develop targeted,rational and effective intervention of suicide attempts,reduce the suicide rate and improve the quality of life of suicide attempters.MethodsAccording to different parts of Shenyang City we randomly select four general hospitals,and collect attempted suicides of emergency room continually each day. From June,2007 to January,2008,there are a total of 403 cases of attempted suicides. Among them,29 cases left the hospital soon after the rescue and could not be surveyed due to less severe diseases,and 37 cases did not conduct a survey due to not meet the standards,and 90 cases refused to cooperate with the investigation,and one case did not complete the investigation,the remaining 239 cases did complete all investigations. When the conditions of suicide attempters improved after rescue,investigators who have passed the systematically training carried out the investigation by suicide general table,and self-injury questionnaire,and Hamilton Depression Rating Scale for Dpression-24,and the "The Structure Clinical Interview For DSM-IV Axis I Disorders-Patient Edition".Psychiatric examination was done by the psychiatric postgraduates with some clinical experience after strict training.Information came from the suicide attempters himself and the one or two families,and for some doubtful cases,more than two psychiatrists confirmed the diagnosis after discussions.ResultsThe prevalence of mental disorders of 239 cases of attempted suicides was overall 69.46%while self-injury,and the highest prevalence of mood disorders for 48.12% (115/239),anxiety disorders for 38.49%(92/239),psychotic obstacles for 8.37% (20/239),alcohol(substance)abuse(or dependence)for 7.11%(17/239),adjustment disorder 4.60%(11/239).during the year before suicide,39.76%(66/166)of the suicide attempters with mental disorders seeked any help because of mental or psychological problems,and only 7.23%(12/166)to see a psychologist or psychiatrist,and take anti-psychosis drugs,anti-depression or anti-anxiety drugs,and so on.Suicide attempters suffering from mental disorders often committed suicide less impulsively, and their purpose was to relieve themselves and reduce the burden of others,so the rate of self-help was lower after their injury occurred;Suicide attempters suffering from mental disorders had more obvious symptoms such as anxiety / somatization,weight loss,recognize obstacles,slow,sleep disorders,sense of despair,and the degree of depression of them were greater(P＜0.05)than ones with no mental disorders,but among suicide attempters suffering from various types of mental disorders there were no significant differences.(P＜0.05).ConclusionThe prevalence of suicide attempts of emergency room in general hospitals was high,but attendance rate before the suicide is so low;Suicide attempters suffering from mental disorders often committed suicide less impulsively,had larger determination of suicide,and their purpose was to relieve themselves and reduce the burden of others,so the rate of self-help was lower after their injury occurred;The depressive components of mental disorders were most related to the suicidal behavior of suicide attempters directly.Therefore,the scores of the severity of depression during 1-2 weeks before suicide is a better indicators that predicts the risk of suicide,and the emphasis of suicide prevention for suicide attempters with different types of mental disorders should focus on the treatment of their depressive symptoms.