背景：自?對國民生產?及生活品質有長期之負面效應，因此其預防變成21 世紀全世界各國之主要公共衛生議題之一。台灣的自?死亡發生?在近十幾??逐?增加，因此對自??為深入?解，進而建?預防的機制，實刻?容緩。蓄意自我傷害（Deliberate Self-Harm, DSH）為自?死亡最重要的預測因子，對 DSH 的研究為近??國際自?學及自?預防的主要?域之一。然而有關DSH 的危險因子之研究幾乎都集中在西方國家，其他地區 (包含亞洲) 則罕?。目的：本研究擬使用標準化的評估方法，以台灣南投縣草屯鎮的DSH 個案為研究對象，探討相關之心?社會及精神疾病危險因子。研究的主要目的有，探討 DSH 個案之精神疾病 (含重鬱症、創傷後壓?障礙、酒精與其他物質使用障礙、性格障礙)，以及心?社會危險因子; 探討 DSH 個案之精神疾病共病性以及探討上述危險因子如何交互作用，而導致 DSH 的高風險。研究方法：本研究將採用配對個案對照研究法 (matched case-control strategy) 選取DSH 個案，並按性別，?齡（相差小於五歲者）及居住區域配對選取對照組。研究對象為18 歲以上，居住在南投縣草屯鎮之DSH 個案，以及非DSH 之居民。本計劃預計收集100 名個案與100 名對照者以中文版神經精神醫學?床評估表、中文版標準化性格評?表、等評估工具，所有的訪談評估將由經過嚴格訓?、評估者間信? (inter-rater reliability) 檢定?好的助? (具精神科?床經驗) 與精神科專業人員進?訪談評估。預期結果：可瞭解蓄意自我傷害者之精神疾患盛??及其共病性; 其他自我傷害之心?社會危險因子，以及這些因子和自?意圖之相關性。 Background: Suicide has long term negative influences on the productivity and quality of life of people, and its prevention becomes the major issue of public health all over the world. The suicide rate has increased gradually in past decade. It is an essential issue to understand the characteristics of suicidal behaviors and establish the system of suicide prevention. Deliberate self-Harm (DSH) is the most important predictive factor of suicide and study on DSH has become the main field of suicide prevention internationally. However, almost all of studies related to the risk factors of DSH were carried out inWestern countries and rarely in Asia areas. Aims: The present study plans to investigate the psychosocial and psychiatric risk factors for DSH cases through standardized assessment instruments in Tsaotun area in Nantou. The main focus will be on the psychiatric disorders (encompassing major depressive disorder, post-traumatic stress disorder, alcohol or substance problems and personality disorder), and other psychosocial factors and comorbidity. The interaction of these factors will be explored to reveal how they led to the risk of DSH. Methods: Amatched case control study, including consecutive DSH cases aged 18 years or older and controls matched for sex, age (within five years) and area of residence. Residents in the Tsaotun area carry out DSH will be recruited in this study. The present study plans to recruit 100 DSH cases and 100 control persons. These participants will be interviewed with SCAN, Chinese version of structured personality assessment and other psychosocial instruments. All interview will be carried out by well-trained assistants with psychiatric clinical experiences and good inter-rater reliability along with psychiatric professionals. Expect contribution: The results will demonstrate the prevalence of psychiatric disorders, comorbidity and other psychosocial factors among DSH cases. It will also clarify the interaction between suicide intent and these factors.
