以五題簡式健康量表（BSRS-5）篩選分數來評估新兵自殺的危險性

Cut-off Values of Five-item Brief Symptom Rating Scale in Evaluating Suicidality among Military Recruits

目的：自殺是重大的全球問題，也是國家公共健康議題。如何篩選軍中服役初期的高危 險個案是必要的。本研究目的是針對不同自殺相關議題在新兵族群中，評估其盛行率、探 討五題簡式健康量表的相關因子及測定其篩選分數。方法：北台灣軍方訓練基地 1,222 名完 成所有問卷的新兵參與研究。簡式健康量表及成人自陳量表等兩份問卷由所有個案填寫，貝 克自殺意念量表僅由曾有自殺相關問題的人填寫。結果：研究顯示軍人在自殺意念，自殺嘗 試及故意自我傷害有高的盛行率。以五題簡式健康量表作為自殺意念、故意自我傷害及自殺 嘗試的篩選工具時，建議篩選分數為 7、8 及 8 並與通用篩選分數相比，有相似曲線下面積 量。另對軍人族群有較佳特定度且針對不同自殺相關議題，相關因子大致相似。結論：研究 結果建議五題簡式健康量表能有效地將自殺相關議題從軍人中區辨出並且新的篩選分數具有 較佳的特定度。此種容易施作的問卷能利於軍中自殺防治執行。

Objectives: Suicide is a big worldwide problem and also a national public health issue. How to screen high-risk soldiers is essential at an early stage of mili-tary service. The objectives of this study were to assess prevalences, to investigate the associated rôle in five-item Brief Symptom Rating Scale (BSRS-5), and to determine the cut-off scores of BSRS-5 in each type of suicidality in new military recruits. Methods: We recruited 1,222 soldiers who completed all copies of ques-tionnaire from a military base in northern Taiwan. The subjects completed the copies of questionnaire of BSRS-5 and Adult Self-Report Scale Inventory-4 (the ASRI), and a copy of questionnaire of the optional Beck Scale for Suicide Ideation (BSS) was also completed for those who had ever had suicidality. Results: This study revealed high prevalences of suicidal ideation (SI), suicidal attempt (SA), and deliberate self-harm (DSH) of military recruits. While using BSRS-5 as a screening instrument for SI, DSH, and SA, the suggested cut-offs were 7, 8, and 8, respectively and had almost the same magnitudes of area under curves compared with the general cut-offs. In addition, better specificity for military recruits was noted and associated factors for each kind of suicidality were almost similar. Conclusion: The study results suggest that BSRS-5 can be efficiently used to distin-guish suicidality from the military recruits and better specificity of new cut-offs. This easily administered tool can help screen high risk suicidal military recruits for suicide prevention