Luoma Jason B, Martin Catherine E, Pearson Jane L
Division of Services and Intervention Research, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
Am J Psychiatry. 2002 Jun;159(6):909-16. doi: 10.1176/appi.ajp.159.6.909.
This study examined rates of contact with primary care and mental health care professionals by individuals before they died by suicide.
The authors reviewed 40 studies for which there was information available on rates of health care contact and examined age and gender differences among the subjects.
Contact with primary care providers in the time leading up to suicide is common. While three of four suicide victims had contact with primary care providers within the year of suicide, approximately one-third of the suicide victims had contact with mental health services. About one in five suicide victims had contact with mental health services within a month before their suicide. On average, 45% of suicide victims had contact with primary care providers within 1 month of suicide. Older adults had higher rates of contact with primary care providers within 1 month of suicide than younger adults.
While it is not known to what degree contact with mental health care and primary care providers can prevent suicide, the majority of individuals who die by suicide do make contact with primary care providers, particularly older adults. Given that this pattern is consistent with overall health-service-seeking, alternate approaches to suicide-prevention efforts may be needed for those less likely to be seen in primary care or mental health specialty care, specifically young men.
本研究调查了自杀身亡者在自杀前与初级保健和精神卫生保健专业人员的接触率。
作者回顾了40项有医疗保健接触率相关信息的研究，并研究了受试者的年龄和性别差异。
在自杀前一段时间内与初级保健提供者接触很常见。四分之三的自杀受害者在自杀前一年内与初级保健提供者有过接触，约三分之一的自杀受害者与精神卫生服务机构有过接触。约五分之一的自杀受害者在自杀前一个月内与精神卫生服务机构有过接触。平均而言，45%的自杀受害者在自杀前1个月内与初级保健提供者有过接触。老年人在自杀前1个月内与初级保健提供者的接触率高于年轻人。
虽然尚不清楚与精神卫生保健和初级保健提供者的接触在多大程度上可以预防自杀，但大多数自杀身亡者确实与初级保健提供者有过接触，尤其是老年人。鉴于这种模式与总体寻求医疗服务的情况一致，对于那些不太可能在初级保健或精神卫生专科护理中就诊的人，特别是年轻男性，可能需要采取其他自杀预防措施。
