Dhossche D M, Meloukheia A M, Chakravorty S
Department of Psychiatry, University of South Alabama College of Medicine, Mobile, Alabama, USA.
Gen Hosp Psychiatry. 2000 Jul-Aug;22(4):281-8. doi: 10.1016/s0163-8343(00)00085-2.
Substance abuse has been associated with attempted suicide and suicide. Few studies have examined the prevalence and associations of combined depression and substance abuse in suicide attempters. A chart review study of 1136 adult general hospital patients referred for psychiatric consultation between 1995 and 1998 was conducted to assess this further. Among 371 cases with self-harm, 311 (84%) attempted suicide. Suicide attempters were younger and diagnosed more often with comorbid substance abuse than patients without self-harm. Depressive disorders were found in 59% and substance abuse disorders in 46%. Comorbid depression and substance abuse was the most frequent category in suicide attempters, i.e., in 37%. Self-reported suicide intent was associated with increasing age, male gender, and comorbid depression and substance abuse. The suicide rate in suicide attempters was 322 per 100,000 patient-years, and 131 per 100,000 in consultation patients without self-harm. It is concluded that comorbid depression and substance abuse is associated with attempted suicide in psychiatric consultation patients. Suicide attempters should be thoroughly assessed for substance abuse. The increased suicide rate in psychiatric consultation patients with and without suicide attempts warrants further research.
药物滥用与自杀未遂及自杀有关。很少有研究探讨自杀未遂者中抑郁症与药物滥用合并存在的患病率及相关性。为进一步评估此情况，对1995年至1998年间转介至精神科会诊的1136名成年综合医院患者进行了一项病历回顾研究。在371例有自我伤害行为的患者中，311例（84%）有自杀未遂行为。与无自我伤害行为的患者相比，自杀未遂者更年轻，且更常被诊断为合并药物滥用。59%的患者存在抑郁障碍，46%存在药物滥用障碍。合并抑郁症和药物滥用是自杀未遂者中最常见的类型，即占37%。自我报告的自杀意图与年龄增长、男性性别以及合并抑郁症和药物滥用有关。自杀未遂者的自杀率为每10万患者年322例，无自我伤害行为的会诊患者为每10万131例。结论是，合并抑郁症和药物滥用与精神科会诊患者的自杀未遂有关。应对自杀未遂者进行药物滥用方面的全面评估。有自杀未遂和无自杀未遂的精神科会诊患者自杀率升高值得进一步研究。
