不同性別之生命態度，憂鬱及自殺意念相關差異研究初探

Sex Difference in Associations among Life Attitudes, Depression, and Suicidal Ideation: A Preliminary Study

目的：憂鬱及生命態度（或稱生命意義）長久來被認為與自殺意念有關，然而三者之間的詳細相關情形尚不明瞭，本研究目的在探索三者之相關，特別是男女性別之異同。方法：本研究隨機採樣某醫院精神科門診候診區候個案（含病人），經取得同意書後以匿名方式自填貝克憂鬱量表 (BDI)，簡氏健康量表 (BSRS) 及25 題之生命態度量表。結果：本研究收集102 名樣本（男性：54，女性：48），其中約1/3 有自殺意念 (n = 32)，有自殺意念組有較多男性 (p < 0.05) 且有較低的各項生命態度分數，如「愛與關懷」，「自我存在」，「生命經驗」，「生命自主」及「生命理想」(all p < 0.01)。路徑分析結果發現，針對男性而言，「自我存在」及「生命理想」的生命態度與憂鬱及自殺意念有關 (p < 0.05)。針對女性而言，「愛與關懷」與憂鬱之相關最明顯(p < 0.01)，而「死亡態度」越能接受死亡者，自殺意念顯著的越低（全部p < 0.01）。討論：本研究結果亦支持男女性之生命態度及自殺意念有所不同。本研究分析不同性別之生命態度—憂鬱—自殺意念路徑之細節及差異，結果應可提供在不同性別之自殺防治介入時重要參考。

Background: Depression and life attitude (or meaning in life) have been noted to be highly associated with suicidal ideation. But the details in the links among them remain still unclear. In this study, we intended to clarify their associations of the sex factor. Method: We randomly selected 102 participants (male: 54, female: 48) from individuals waiting in a psychiatry clinic waiting room with their consents. They were asked to complete copies of Beck Depression Inventory (BDI), Brief Self-Report Scale (BSRS), and 25-item Life Attitude questionnaire, anonymously. Result: About one third (n = 32) of participants had positive suicidal ideation. They were signifi cantly more to be males participants (p < 0.05) and responded signifi cantly more lower subscales of “belonging” (p < 0.01), “existence” (p < 0.01), “life experience” (p < 0.01), “life control” (p < 0.01), and “goal seeking” (p < 0.01). The path analysis showed that, their more positive life attitudes of “existence” and “goal seeking” are signifi cantly negatively associated with suicidal ideation and depression (p < 0.05). But in female participants the infl uence of higher “belonging” was the most signifi cant on lower depression (p < 0.01), whereas higher “death acceptance” showed negative association with suicidal ideation (all p < 0.01). Conclusion: In line with existing evidences, sex difference in life attitude and suicidal ideation exists. This study distinguishes the life attitudedepression- suicidal ideation path in gender. Our fi ndings provides further insights in sex-specifi c suicide prevention interventions.