Skopek M A, Perkins R
Department of Liaison Psychiatry, Prince of Wales Hospital, New South Wales, Australia.
Aust N Z J Psychiatry. 1998 Dec;32(6):830-8. doi: 10.3109/00048679809073873.
Deliberate exposure to motor vehicle exhaust gas has become the second most commonly used method of suicide in Australia. In an attempt to understand the factors contributing to the rise in popularity of this method, the psychosocial profiles, factors influencing method choice and circumstances of the act of self-harm were examined in a group of survivors.
A cross-sectional cohort study of 30 patients presenting for hyperbaric oxygen treatment having survived deliberate exposure to car exhaust gas was undertaken. A structured clinical interview was administered together with scales measuring depression, hopelessness and suicidal intent. Daily assessment of mental state and cognitive function was performed.
Factors common to the majority of subjects included male gender, age group of 20-50 years, and alcohol abuse. Relationship discord was the most common precipitating factor. Reasons given for choice of this method included the availability and accessibility of motor vehicles, painlessness, awareness that the method was lethal, knowledge of another person's successful suicide by this method and awareness of the method through media portrayal. Most of the cars used did not have engines fitted with catalytic converters, substantially increasing the risk of toxicity. Regret of the attempt, denial of further suicidal ideation after the event, and the absence of a suicide note were common findings. Most denied excessive time spent planning. The most common diagnosis in this group was adjustment disorder with depressed mood. Suicide intent scores were not high, inconsistent with the majority of patients being aware of the lethality of the method.
Sociodemographic findings resemble those of psychological autopsy studies of subjects completing suicide by this method. Survival in this group was due to failure of the method or unexpected discovery rather than patient factors. This population described the method as highly acceptable and accessible emphasising the urgent need for reduction of access to this means of suicide in Australia.
在澳大利亚，故意暴露于机动车尾气已成为第二大最常用的自杀方式。为了试图了解导致这种方式流行率上升的因素，对一组幸存者的心理社会概况、影响方式选择的因素以及自残行为的情况进行了研究。
对30名因故意暴露于汽车尾气而幸存并前来接受高压氧治疗的患者进行了横断面队列研究。进行了结构化临床访谈，并使用了测量抑郁、绝望和自杀意图的量表。对心理状态和认知功能进行了每日评估。
大多数受试者共有的因素包括男性、20 - 50岁年龄组和酗酒。关系不和是最常见的促发因素。选择这种方式的原因包括机动车的可得性和易接近性、无痛、意识到该方式具有致命性、知晓他人通过这种方式成功自杀以及通过媒体报道了解到该方式。大多数使用的汽车没有安装催化转化器，这大大增加了中毒风险。对尝试感到后悔、事件发生后否认有进一步的自杀念头以及没有遗书是常见的情况。大多数人否认花费过多时间进行计划。该组中最常见的诊断是伴有抑郁情绪的适应障碍。自杀意图得分不高，这与大多数患者意识到该方式的致命性不一致。
社会人口学研究结果与通过这种方式完成自杀的受试者的心理解剖学研究结果相似。该组患者存活是由于方式失败或意外发现，而非患者自身因素。这群人将这种方式描述为极易接受且容易实施，强调在澳大利亚迫切需要减少获取这种自杀方式的途径。
