使用 SAD PERSONS及 Modified SAD PERSONS量表分析自殺嚴重性的相關因子

Analysis of Multiple Suicide Risk Factors of Psychiatric Inpatients by Severity Using the SAD PERSONS and Modifi ed SAD PERSONS Scale in Taiwan

目的：自殺在台灣是個重大公共衛生議題，因此，我們需要分析從Modified SAD PERSONS 以及SAD PERSONS 量表篩選的十三個評估項目與本土自殺資料的關聯性。方法：此 回朔性研究收案210 個住院病人，以病歷回顧的方式，將病人分為三組：非自殺組、自殺意 念組以及自殺企圖組，分配給精神科專科醫師進行十三個項目的的評分後，以卡方分析檢 驗三組不同自殺嚴重度的個案在一般人口學、此十三個自殺風險項目的差異性，再進一步 以邏輯式回歸方法檢驗自殺與這些風險項目的相關性。 結果：年齡 (p < 0.01)、憂鬱症狀 (p < 0.001)、自殺史 (p < 0.001)、思考障礙 (p < 0.001)、自殺計畫 (p < 0.001)、自己陳述未來自殺 企圖 (p < 0.001) 與目前生活壓力 (p < 0.001) 等項目在三組個案間達到顯著地差異性，而更進 一步可發現這些項目與自殺嚴重度呈現正相關性。結論：除了年齡以及思考障礙兩個項目以 外，其他項目在本土資料的發現與國外文獻的發現相似。

Background: Suicide risk evaluation is a public health priority in Taiwan. In this preliminary study, we intended to do a correlation study between 13 individual items derived from the Modifi ed SAD PERSONS scale and the SAD PERSONS scale relative to suicide among ethnic Chinese subjects. Methods: We retrospectively reviewed 210 inpatient medical records and classifi ed patients’ suicidal severity into three groups: (A) non-suicide group, (B) suicidal ideation group, and (C) attempted suicide group for analysis. Results: Seven items -- age (p < 0.01), depression (p < 0.001), previous attempt (p < 0.001), rational thought loss (p < 0.001), organized plan (p < 0.001), stated future intent (p < 0.001), and current life stressor (p < 0.001) were signifi cant, indicating that these seven risk factors are distinctly important among these groups. Further group-to-group relationships showed that the “the proportion of the suicidal ideation group or attempted suicide group was always signifi cantly greater than that of the non-suicide group” in most factors, except those correlated to “age” and “rational thought loss” factors. Conclusion: Five factors -- depression (p < 0.05), previous attempt (p < 0.01), organized plan (p < 0.01), stated future intent (p < 0.01), and current life stressor (p < 0.01) were signifi cantly to be strongly associated with suicide in our study. Among the factors,“organized plan” and “previous attempt” were strongest signifi cant predictors.