Houston K, Hawton K, Shepperd R
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
J Affect Disord. 2001 Mar;63(1-3):159-70. doi: 10.1016/s0165-0327(00)00175-0.
The suicide rate in young people in the United Kingdom has increased over the last decade. As there is a paucity of information about the characteristics of young suicides we have undertaken a detailed investigation of suicides in people aged 15-24 years by means of the psychological autopsy approach.
The sample consisted of 27 subjects (25 males, two females) whose deaths received a verdict of suicide (N=24) or undetermined cause (N=3). Information was collected from informant interviews, coroners' inquest notes, medical records and psychiatric case notes. A sub-sample of 22 male subjects was compared with an age-matched sample of male deliberate self-harm (DSH) patients.
Psychiatric disorders were diagnosed in 19 (70.4%) subjects. These were most commonly depressive disorders (55.5%). Very few individuals were receiving treatment for their disorders. Substance abuse disorders were uncommon but a substantial proportion of individuals had problems with alcohol or drug misuse. Personality disorders were present in 29.6% of subjects and disorders or personality trait accentuation in 55.6%. Comorbidity of psychiatric disorders was found in a third of subjects. The suicides were often the end-point of long-term difficulties extending back to childhood or early adolescence. In addition to mental disorders, relationship and legal difficulties were identified as relatively common contributory factors to the suicides. In comparison to deliberate self-harm patients, male suicides were more likely to use dangerous methods and live alone.
Several potential informants could not be interviewed and there was no general population control sample.
The process leading to suicide in young people is often long term, with untreated depression in the context of personality and/or relationship difficulties being a common picture at the time of death. The prevention of suicide in the young clearly requires multiple strategies.
在过去十年中，英国年轻人的自杀率有所上升。由于关于年轻自杀者特征的信息匮乏，我们采用心理解剖方法对15至24岁人群的自杀情况进行了详细调查。
样本包括27名受试者（25名男性，2名女性），其死亡判定为自杀（N = 24）或死因不明（N = 3）。通过对 informant 的访谈、验尸官的询问记录、医疗记录和精神科病例记录收集信息。将22名男性受试者的子样本与年龄匹配的男性蓄意自伤（DSH）患者样本进行比较。
19名（70.4%）受试者被诊断患有精神疾病。最常见的是抑郁症（55.5%）。很少有人因疾病接受治疗。物质滥用障碍并不常见，但相当一部分人存在酒精或药物滥用问题。29.6%的受试者存在人格障碍，55.6%的受试者存在人格障碍或人格特质加重。三分之一的受试者存在精神疾病共病情况。自杀往往是可追溯到童年或青春期早期的长期困难的终点。除精神障碍外，人际关系和法律问题被确定为自杀相对常见的促成因素。与蓄意自伤患者相比，男性自杀者更有可能使用危险方法且独居。
无法对几位潜在 informant 进行访谈，且没有一般人群对照样本。
年轻人自杀的过程往往是长期的，在死亡时，人格和/或人际关系困难背景下未经治疗的抑郁症是常见情况。显然，预防年轻人自杀需要多种策略。
