مقایسه مکانیسم های تطابقی در بیماران با مسمومیت های عمدی با گروه کنترل

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 استاد، گروه سم شناسی بالینی. مرکز تحقیقات سم شناسی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 دانشیار، گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران. مرکز تحقیقات آموزش علوم پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

هدف: خودکشی در جوامع بشری به عنوان یک معضل عمده بهداشت عمومی بشمار می رود و به نظر می رسد روابط اجتماعی، استرس های محیطی و نحوه برخورد با این عوامل توسط فرد، در بروز خودکشی نقش مهمی دارد. مطالعه حاضر با هدف بررسی مکانیسم های تطابقی مختلف و ارتباط آنها با اقدام به خودکشی انجام شده است.
روش اجرا: این مطالعه به صورت مورد-شاهدی انجام شده است. برای انجام این مطالعه 40 نفر از افرادی که بدلیل اقدام به خودکشی به بخش مسمومین بیمارستان مراجعه کرده بودند، با نمونه گیری در دسترس وارد مطالعه شدند. از طرفی، از میان بیمارانی که به دلایل دیگر بجز خودکشی به بیمارستان مراجعه کرده بودند نیز 40 نفر که از جهات مختلف، مشابه گروه مورد بودند وارد مطالعه شدند. برای بررسی مکانیسم های مقابله ای از پرسشنامه مبنی بر تئوری لازاروس استفاده شده است.
یافته‌ها: از میان مکانیسم های تطابقی، امتیاز مربوط به مکانیسم های بازبراورد مثبت، خویشتن داری و جستجوی حمایت اجتماعی بصورت معنی داری در گروه مورد کمتر بوده است (به ترتیب P=0.020 ، P=0.016 ، P=0.040). مکانیسم های گریز و اجتناب و رویاگونه در گروه مورد بیشتر از گروه شاهد بوده است، با اینحال این تفاوت از نظر آماری معنی دار گزارش نشده است (به ترتیب P=0.65 و P=0.10).
نتیجه‌گیری: نتایج این مطالعه نشان داد که مکانیسم های تطابقی با توجه به کارآمد یا نارکارآمد بودن می توانند باعث کاهش یا افزایش ریسک اقدام به خودکشی شوند. با اینحال انجام مطالعات بیشتر برای اثبات این رابطه ضروری می باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of coping mechanisms in patients with intentional poisoning with the control group

نویسندگان [English]

  • Koroosh Parhizgar 1
  • Bita Dadpour 2
  • Majid Khadem-Rezaiyan 3
1 Medical Student, School of Medicine, Mashhad University o Medical Sciences
2 Professor, Department of Clinical Toxicology, Medical Toxicology Ressearch Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Associate Professor, Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Medical Sciences Education Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
چکیده [English]

Introduction: Suicide is considered a major public health problem in human societies, and it seems that social relations, environmental stress and the way an individual deals with these factors play an important role in the occurrence of suicide. The aim of the present study was to investigate various coping mechanisms and their relationship with suicide attempts.
Methods: This case-control study was perfomed on patients referred to Imam Reza Hospital (AS) in Mashhad, Iran. Forty patients who had referred to the poisoning department of the hospital due to suicide attempts were included in the study with convenient sampling method. On the other hand, 40 patients who were similar to the case group in various aspects were selected and included in the study. Data collection was done using a checklist including demographic information and the method and manner of committing suicide. Also, a questionnaire based on the Lazarus theory has been used to investigate coping mechanisms.
Results: Among the coping mechanisms, the score related to the mechanisms of positive feedback, self-control, and seeking social support was significantly lower in the case group (P=0.020, P=0.016, P=0.040, respectively). Avoidance and dreamlike mechanisms were more common in the case group than in the control group, however, this difference was not statistically significant (P=0.65 and P=0.10, respectively).
Conclusion: The results of this study showed that coping mechanisms can reduce or increase the risk of suicide, depending on whether they are efficient or ineffective. However, more studies are necessary to prove this relationship.

کلیدواژه‌ها [English]

  • suicide
  • coping mechanism
  • poisoning

مراجع

  1. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459-544.
  2. Borges G, Nock MK, Abad JMH, Hwang I, Sampson NA, Alonso J, et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. The Journal of clinical psychiatry. 2010;71(12):21777.
  3. Brown RC, Plener PL. Non-suicidal Self-Injury in Adolescence. Current psychiatry reports. 2017;19(3):20.
  4. Rezaeian M. Age and sex suicide rates in the Eastern Mediterranean Region based on global burden of disease estimates for 2000. EMHJ-Eastern Mediterranean Health Journal, 13 (4), 953-960, 2007. 2007.
  5. Oquendo MA, Volkow ND. Suicide: A Silent Contributor to Opioid-Overdose Deaths. The New England journal of medicine. 2018;378(17):1567-9.
  6. Ivey-Stephenson AZ, Crosby AE, Jack SPD, Haileyesus T, Kresnow-Sedacca MJ. Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death - United States, 2001-2015. Morbidity and mortality weekly report Surveillance summaries (Washington, DC : 2002). 2017;66(18):1-16.
  7. Han B, Kott PS, Hughes A, McKeon R, Blanco C, Compton WM. Estimating the rates of deaths by suicide among adults who attempt suicide in the United States. Journal of psychiatric research. 2016;77:125-33.
  8. Phillips JA, Hempstead K. Differences in U.S. Suicide Rates by Educational Attainment, 2000-2014. American journal of preventive medicine. 2017;53(4):e123-e30.
  9. Hirschfeld RM, Russell JM. Assessment and treatment of suicidal patients. The New England journal of medicine. 1997;337(13):910-5.
  10. Bostwick JM, Pankratz VS. Affective disorders and suicide risk: a reexamination. The American journal of psychiatry. 2000;157(12):1925-32.
  11. Fortinash KM, Worret PAH. Psychiatric mental health nursing: Elsevier Health Sciences; 2014.
  12. Spann M, Molock SD, Barksdale C, Matlin S, Puri R. Suicide and African American teenagers: Risk factors and coping mechanisms. Suicide and Life‐Threatening Behavior. 2006;36(5):553-68.
  13. Sarason IG, Sarason BR. Abnormal psychology: The problem of maladaptive behavior: Prentice-Hall, Inc; 1987.
  14. Cohen F, Lazarus RS. Coping with the stresses of illness. health psychol ogy/F Cohen, R Lazarus. 1979.
  15. Linehan MM, Chiles JA, Egan KJ, Devine RH, Laffaw JA. Presenting problems of parasuicides versus suicide ideators and nonsuicidal psychiatric patients. Journal of consulting and clinical psychology. 1986;54(6):880.
  16. Rydin E, Åsberg M, Edman G, Schalling D. Violent and nonviolent suicide attempts—a controlled Rorschach study. Acta Psychiatrica Scandinavica. 1990;82(1):30-9.
  17. Patsiokas AT, Clum GA, Luscomb RL. Cognitive characteristics of suicide attempters. Journal of Consulting and Clinical Psychology. 1979;47(3):478.
  18. Schotte DE, Clum GA. Suicide ideation in a college population: a test of a model. Journal of consulting and clinical psychology. 1982;50(5):690.
  19. Levenson M, Neuringer C. Problem-solving behavior in suicidal adolescents. Journal of Consulting and Clinical Psychology. 1971;37(3):433.
  20. Votta E, Manion I. Suicide, high-risk behaviors, and coping style in homeless adolescent males' adjustment. Journal of adolescent health. 2004;34(3):237-43.
  21. Mehdizadegan I, Raeesi N. Relationship Of Religious Beliefs, Identity Styles And Personality Traits With Depression Among Female Students. Scientific Research Quarterly of Woman and Culture. 2016;7(26):33-54.
  22. Behzadipur S, SepahMansour M, KeshavarziArshad F, Farzad V, Naziri G, Zamanian S. Effectiveness of Stress Management Based on Cognitive-Behavioral Intervention on Guality of Life and Coping Styles for Female with Breast Cancer. Psychological Methods and Models, 2013; 3(12): 29-46.
  23. Shakeri J, Parvizifard A A, Sadeghi K, Moradi R. Personality Traits, Stress, Coping and Religious Attitudes among Individuals Attempting Suicide. IJPCP 2006; 12 (3) :244-250
  24. Lim J, Bogossian F, Ahern K. Stress and coping in Singaporean nurses: a literature review. Nursing & Health Sciences. 2010;12(2):251-8.
  25. Phillips JK. Exploring student nurse anesthetist stressors and coping using grounded theory methodology. AANA journal. 2010;78(6):474.
  26. Beautrais A. Suicide in New Zealand II: A review of risk factors and prevention. NZ Med J. 2003;116(1175):U461.
  27. Jahangir, M.R. Bazrafshan, A.R. Zangoee, T. Raeisi, (2009). Comparison of coping mechanisms used by suicidal attempt patients, and those without suicidal history, Hormozgan Medical Journal, 13(2), 109-113.
  28. Montazeri A, Mousavi SJ, Omidvari S, Tavousi M, Hashemi A, Rostami T. Depression in Iran: a systematic review of the literature (2000-2010), Payesh 2013, 12(6), 567-594.
  29. Khatibi Moghaddam H, Moharreri F, Rahmani Fard A, Khadem Rezaiyan M. Epidemiology of psychiatric disorders: The situation of Mashhad city during 2010-2016. Journal of Fundamentals of Mental Health 2017 Nov-Dec; 19(6): 451-60.
  30. Josepho SA, Plutchik R. Stress, coping, and suicide risk in psychiatric inpatients. Suicide and Life‐Threatening Behavior. 1994;24(1):48-57.
  31. Xiao H, Li X, Zhou Z, Liu H, Hu C, Liu T, et al. Negative coping style mediates the relationship between negative mental and suicide risk among migrant workers in China. Scientific Reports. 2022;12(1):305.
  32. Control CfD, Prevention. Mental health in the United States: health risk behaviors and conditions among persons with depression--new Mexico, 2003. MMWR Morbidity and mortality weekly report. 2005;54(39):989-91.
  33. Khajedalui M, Khatibi Moghadam H, Goldani F, Nojar A, Khadem-Rezaiyan M . Coping strategies in suicide attempters Journal of Fundamentals of Mental Health 2021 Sep-Oct; 23(5): 317-322.
  34. Ahmadzade AM, Ahmadabadi A, Tavousi SH, Khadem-Rezaiyan M. Main Coping Style of Self-Immolation Patients. Avicenna Journal of Clinical Medicine. 2024 Mar 15;30(4):225-32.
  35. Coyne JC, Aldwin C, Lazarus RS. Depression and coping in stressful episodes. Journal of abnormal psychology. 1981;90(5):439.
  36. Bolton JM, Belik SL, Enns MW, Cox BJ, Sareen J. Exploring the correlates of suicide attempts among individuals with major depressive disorder: findings from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2008;69(7):1139-49.
  37. Bolton JM, Cox BJ, Afifi TO, Enns MW, Bienvenu OJ, Sareen J. Anxiety disorders and risk for suicide attempts: findings from the Baltimore Epidemiologic Catchment area follow-up study. Depression and anxiety. 2008;25(6):477-81.
  38. Ribeiro JD, Huang X, Fox KR, Franklin JC. Depression and hopelessness as risk factors for suicide ideation, attempts and death: meta-analysis of longitudinal studies. The British journal of psychiatry : the journal of mental science. 2018;212(5):279-86.
  39. Hawton K, Fagg J. Suicide, and other causes of death, following attempted suicide. The British Journal of Psychiatry. 1988;152(3):359-66.
  40. Hawton K, Arensman E, Wasserman D, Hulten A, Bille-Brahe U, Bjerke T, et al. Relation between attempted suicide and suicide rates among young people in Europe. Journal of Epidemiology & Community Health. 1998;52(3):191-4.
  41. Hawton K, Van Heeringen K. The international handbook of suicide and attempted suicide: John Wiley & Sons; 2000.
  42. Rezaiyan MK, Jarahi L, Moharreri F, Afshari R, Motamedalshariati SM, Okhravi N, Khajedaluee M. Epidemiology of suicide attempts in Khorasan Razavi Province, 2014-2015. Iranian journal of epidemiology. 2017;13(2): 128-135.
  43. Masango S, Rataemane S, Motojesi A. Suicide and suicide risk factors: A literature review. South African Family Practice. 2008;50(6):25-9.
  44. Hashemi fard, A., Saffari, S. E., Ghasemi Hosseinabadi, A., Hashemifard, H., Hashemifard, M. Adetermination ofthe effective factors on Suicide attempt amongpatients of Vasei Hospital of Sabzevar in 2013. Journal of Sabzevar University of Medical Sciences, 2015; 22(1): 84-92.
  45. Khajedaluee M, Khadem-Rezaiyan M, Jarahi L, Khatibi-Moghadam H, Faridpak A. Suicidal continuum (ideation, planning, attempting) in an Islamic country; which should be focused on?. Journal of injury and violence research. 2021 Jan;13(1):47-54.
  46. McKeown RE, Cuffe SP, Schulz RM. US suicide rates by age group, 1970–2002: an examination of recent trends. American journal of public health. 2006;96(10):1744-51.
  47. Appleby L, Shaw J, Amos T, McDonnell R, Harris C, McCann K, et al. Suicide within 12 months of contact with mental health services: national clinical survey. Bmj. 1999;318(7193):1235-9.
  48. Qin P, Agerbo E, Westergård-Nielsen N, Eriksson T, Mortensen PB. Gender differences in risk factors for suicide in Denmark. The British journal of psychiatry. 2000;177(6):546-50.
  49. Agerbo E, Gunnell D, Mortensen P, Eriksson T, Qin P, Westergaard-Nielsen N. Risk of suicide in relation to income level in people admitted to hospital with mental illness: nested case-control studyCommentary: Suicide and income—is the risk greater in rich people who develop serious mental illness? Bmj. 2001;322(7282):334-5.
  50. Jacobs DG, Baldessarini RJ, Conwell Y, Fawcett JA, Horton L, Meltzer H, et al. Assessment and treatment of patients with suicidal behaviors. APA Practice Guidelines. 2010;1:183.
  51. Mohseni S, Mirgol A, Moradi J. Predicting suicidal ideation based on irrational beliefs and rumination of students (psychology and educational sciences) Payame Noor. Horizon of Medical Education Development, 2023; 14(2): 77-65. doi: 10.22038/hmed.2022.58230.1156
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 67، شماره 1
شماره فروردین-اردیبهشت1403
فروردین و اردیبهشت 1403
صفحه 1-15

فایل ها

هم رسانی

ارجاع به این مقاله

آمار