Consortium PSYCHIATRICUMConsortium PSYCHIATRICUMConsortium PSYCHIATRICUM2712-76722713-2919Eco-Vector16110.17816/CP161RESEARCHИССЛЕДОВАНИЕResearch ArticlePsychosocial and Psychiatric Factors Associated with Expected Fatality during Suicide Attempt in Men and WomenПсихосоциальные и психиатрические факторы, связанные с ожидаемым летальным исходом у молодых мужчин и женщин во время суицидальной попыткиhttps://orcid.org/0000-0002-9641-71201978-9868RozanovVsevolod A.РозановВсеволод Анатольевич
Russian Federation

MD, PhD, Professor, Chair of Psychology of Health and Deviant Behavior, Department of Psychology, Chief Scientist, Department of Borderline Disorders and Psychotherapy

v.rozanov@spbu.ruSt. Petersburg State UniversityСанкт-Петербургский государственный университетV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyНМИЦ психиатрии и неврологии им. В.М. Бехтерева17062022050720223248591702202230052022Copyright ©; 2022, Rozanov V.A.Copyright ©; 2022, Розанов В.А.2022Rozanov V.A.Розанов В.А.https://creativecommons.org/licenses/by/4.0https://consortium-psy.com/jour/article/view/161

BACKGROUND: Differential factors that influence intention and subjectively perceived fatality during non-fatal suicidal acts amongst men and women have rarely been explored in the extant literature. Exploring these factors may help to understand how they influence medical outcomes and may also be used in a post-crisis counselling. This study aims to assess factors influencing intent in relation to expected fatality during suicidal acts in men and women.

METHOD: In the current study, 433 individuals who attempted suicide (age 24.89±0.98 years, male/female ratio=1.29) were surveyed using the WHO-5 Well-Being Index, Beck Depression Inventory, Beck Suicide Intent Scale, Plutchik Feelings and Acts of Violence Scale, and Spielberger State/Trait Anger Scale. Life stress was evaluated as an accumulation of negative life events, whilst psychiatric disorders were assessed using CIDI 2.1 inventory.

RESULTS: It was found that the higher expected fatality was associated with higher suicide intention scores, whereas the medical severity of attempts and violent/non-violent attempts distribution did not differ between groups. Although there was no difference in suicide intent scores and medical severity between men and women, men demonstrated a 2.4–3.5 times higher proportion of violent attempts, depending on the group. Higher perceived fatality was associated with lower general well-being, higher depression and violence, hopelessness, and total life stress in men, whereas among women higher perceived fatality was only associated with total life stress. Moreover, in men and women, higher intent and expected fatality was associated with a differential set of negative life events that occurred during childhood. The prevalence of mental health disturbances in the entire sample was about 50% and equally distributed among men and women. However, addictions prevailed among men, while neurotic and stress-related disorders were more common among women. Among those who expected more fatality the number of people with diagnoses and comorbidity was higher, especially in men.

CONCLUSION: There is a difference in risk factors for expected fatality and intent in men and women attempting suicide, which may not necessarily result in severe medical outcomes but may help during the post-crisis counseling of suicide attempters. Expected fatality deserves more attention as a component of general intent. An in-depth study of this phenomenon may help to understand motives of men and women attempting suicide and help prevent future suicidal attempts.

ВВЕДЕНИЕ: Факторы, влияющие на намеренность суицидального акта и ожидание летального исхода у мужчин и женщин в момент суицидальной попытки недостаточно изучены. Их изучение позволит лучше понять, насколько они влияют на исход попытки, а также как они могут быть использованы при посткризисном консультировании с целью превенции повторных попыток и завершенного суицида. Целью работы было изучение намеренности в связи с ожидаемым летальным исходом во время суицидальной попытки у мужчин и женщин.

МЕТОДЫ: Были опрошены 433 человека после попытки суицида (возраст 24,89±0,98 года, соотношение мужчин и женщин=1,29). Использованы индекс благополучия WHO-5, шкала депрессии и шкала намеренности суицидальных действий Бека, шкала оценки насильственных действий Плутчика и шкала характеристик гнева Спилбергера. Стресс оценивали по накоплению негативных событий жизни, психиатрический статус определяли с помощью опросника CIDI 2.1.

РЕЗУЛЬТАТЫ: Чем более вероятным представлялся летальный исход, тем больше баллов по шкале намеренности набирали респонденты, однако при этом нарастания степени тяжести медицинских последствий попытки и доли попыток, совершенных более насильственными способами (X70–X84) не наблюдалось. Значимых отличий в степени намеренности и тяжести попыток между мужчинами и женщинами внутри групп не выявлено. В то же время, среди мужчин доля насильственных способов была в 2,4–3,5 выше в зависимости от группы. У мужчин ожидание летального исхода было ассоциировано со сниженным психологическим благополучием, высокими баллами депрессии и склонности к насильственным действиям, а также с общим уровнем жизненного стресса, в то время как у женщин — только с уровнем стресса. Кроме того, у мужчин и женщин ожидание летального исхода было связано с различным набором негативных стрессовых событий жизни, с которыми им пришлось столкнуться в детском возрасте. Примерно 50% мужчин и женщин имели тот или иной психиатрический диагноз, но среди мужчин преобладали аддикции, а среди женщин — невротические и постстрессовые расстройства. Среди тех, кто считал летальный исход более вероятным, доля лиц с диагнозами и степень коморбидности была выше, среди мужчин значимо.

ЗАКЛЮЧЕНИЕ: Выявлены различающиеся факторы субъективно ожидаемой летальности и намеренности у молодых мужчин и женщин при совершении суицидальной попытки, которые не обязательно приводят к более тяжелым медицинским последствиям, но которые могут быть использованы при посткризисном консультировании. Субъективное ожидание летального исхода в момент попытки как компонент намеренности суицидального акта заслуживает большего внимания, как в плане лучшего понимания психологии мужчин и женщин при совершении попытки, так и с позиций превенции повторных попыток и завершенного суицида.

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