適應障礙軍人的生活品質和自殺意念

Purpose: To identify risk factors involved in the development and precipitation of suicidal behavior in involuntary military recruits. In the past, studies associated with solider suicidal behavior have focused on demographics, self-harm history and psychiatric history. Few studies have examined the positive health perspective on the mental health of soldiers and adjustment disorder of suicidal behavior in this population. This study investigated the associations between quality of life and suicidal ideation and compared the differences in the quality of life of soldiers with suicidal ideation and those without.
Methods: The participants consisted of 140 soldiers with adjustment disorder. The clinical assessments included WHOQOL-BREF Taiwan Version and Beck Suicide Scale (BSS) administered at the waiting room of psychiatry clinics.
Results: All subscales of quality of life were significantly and negatively associated with suicidal ideation. Analyses indicated that physical health (p<.001) and psychological state (p<.001) could predict suicidal ideation. Subjects with suicidal ideation had significantly lower scores on all subscales of quality of life, compared to those soldiers without suicidal ideation.
Conclusions: Physical health and psychological state, two subscales of quality of life, were significantly related to suicidal ideation of soldiers with adjustment disorder.
目的：探討自殺行為的發展過程，確認自殺的相關危險因子是很重要的。過去的研究中，針對軍中士兵出現的自殺行為相關因素探討，主要是社會人口學變項，自傷行為和過去精神科就醫病史。較少的研究是從正面的健康角度探討士兵的自殺行為，此外過去文獻也指出自殺行為與被診斷環境適應障礙的軍人有很大的關聯。本研究目的在探討適應障礙軍人的生活品質和自殺意念的關係，及有自殺及無自殺意念的軍人在各項生活品質的層面是否有顯著差異。
方法：參加者為診斷適應障礙的軍人，共140位。臨床工具的評估包括台灣簡明版生活品質量表(WHOQOL-BREF Taiwan Version)，貝克自殺量表(Beck Suicide Scale)。研究進行方式由研究人員給予前來精神科就診的軍人填寫相關問卷及同意書。診斷準則是由精神科專科醫師根據美國精神醫學會所出版的心理疾病診斷與統計手冊(DSM-IV)診斷為環境適應障礙者，排除精神分裂症者、重鬱症者、藥酒癮濫用症者、智能不足等其他診斷。
結果：研究結果顯示所有生活品質的變項，都與自殺意念有顯著的負相關。生活品質中的身體健康層面和心理狀態層面可以預測自殺意念(p<.001)。有自殺意念的軍人在所有的生活品質變項，顯著地比無自殺意念的軍人得分低。
結論：生活品質中的身體健康及心理狀態與適應障礙軍人的自殺意念有顯著的關係。