Lawrence D, Almeida O P, Hulse G K, Jablensky A V, Holman C D
Department of Psychiatry and Behavioural Science, University of Western Australia, Perth, Australia.
Psychol Med. 2000 Jul;30(4):813-21. doi: 10.1017/s0033291799002391.
Suicide rates are high in later life. Risk factors include male sex and depressive illness. This study investigated the relationship between suicidal behaviour and contact with mental health services among the elderly in Western Australia.
Record linkage was used to obtain records of hospital admissions and mental health service contacts for all suicide attempts and deaths in the period 1980-95. Standardized incidence ratios were calculated for the elderly, general population and people with mental health service contacts. Cox regression was used to evaluated potential risk factors for elderly people who were in contact with mental health services.
People over 60 years of age accounted for 15% of suicides and 4.6% of attempted suicides. Suicide rates were 3.3 times higher in males and 4.4 times higher in females when compared to the general population of elderly people. For attempted suicide, the rate was 5.8 times higher in males and 6.6 times higher in females with prior contact with mental health services. Highest risk of suicide was found in patients with diagnoses of affective psychoses (RR = 3.7), adjustment reaction (RR = 3.2) or depressive disorder (RR = 2.8). The diagnosis of cancer was associated with decreased risk of suicide (RR = 3.6) and attempted suicide (RR = 1.9).
Suicide rates are high among the elderly in Western Australia. Suicide is significantly associated with the diagnosis of mood disorder. Suicide attempts are less common, and are associated most strongly with mood and personality disorders. The decreased risk of self-harm behaviour among patients with cancer warrants further investigation.
晚年自杀率很高。风险因素包括男性和抑郁症。本研究调查了西澳大利亚老年人自杀行为与心理健康服务接触之间的关系。
采用记录链接法获取1980 - 1995年期间所有自杀未遂和死亡的住院记录及心理健康服务接触记录。计算老年人、普通人群以及有心理健康服务接触者的标准化发病率比。使用Cox回归评估与心理健康服务有接触的老年人的潜在风险因素。
60岁以上人群占自杀人数的15%，自杀未遂人数的4.6%。与老年普通人群相比，男性自杀率高3.3倍，女性高4.4倍。对于自杀未遂，有心理健康服务接触史的男性发生率高5.8倍，女性高6.6倍。诊断为情感性精神病（相对危险度=3.7）、适应性反应（相对危险度=3.2）或抑郁症（相对危险度=2.8）的患者自杀风险最高。癌症诊断与自杀风险降低（相对危险度=3.6）和自杀未遂风险降低（相对危险度=1.9）相关。
西澳大利亚老年人自杀率很高。自杀与情绪障碍诊断显著相关。自杀未遂情况较少见，且与情绪和人格障碍关联最为密切。癌症患者自伤行为风险降低值得进一步研究。
