Fruehwald Stefan, Frottier Patrick, Matschnig Teresa, Koenig Franz, Lehr Stephan, Eher Reinhard
Clinical Department of Social Psychiatry, Vienna General Hospital, Waehringer Guertel 18-20, A-1090, Austria.
Psychiatry Res. 2004 Jan 1;121(3):263-9. doi: 10.1016/s0165-1781(03)00253-1.
An unequal distribution of suicides over months and seasons has been a consistent finding in epidemiological surveys on suicide. Jails and prisons are a high-risk setting for suicide all over the world. The high prevalence of both outward and self-directed violence in prison populations indicates dysfunctional central serotonin (5-HT) neurotransmission and, therefore, could account for an unequal distribution of suicides over months and seasons due to underlying bioclimatic factors. Within a total survey of suicides in the Austrian penitentiary system, the weekly, monthly and seasonal distribution of custodial suicides between 1947 and 1999 was studied. After an explorative comparison of suicide distribution over weekdays, months and seasons of the year by chi2-tests, a harmonic Poisson regression model was performed to detect seasonality of suicides. No unequal distribution of suicides was evident over the 53-year period. A limitation of this study was its sample size of 412, a low number compared with population-based samples, where a spring suicide peak was consistently found. An explanation for lacking seasonality could be that bioclimatic factors are less relevant in urban, industrialized areas, where jails and prisons usually are located. One of the core characteristics of penal institutions is the limited possibility for communication and social interaction. This social isolation is independent of seasonal changes. If the individual's possibilities for social interactions are limited, the influence of seasonal changes in social activities may be less relevant. This could explain the absence of seasonal changes in custodial suicide incidence.
自杀在数月和季节间分布不均,这是自杀流行病学调查中一直存在的发现。监狱是全球自杀的高风险场所。监狱人群中外向性暴力和自我导向性暴力的高发生率表明中枢5-羟色胺(5-HT)神经传递功能失调,因此,可能由于潜在的生物气候因素导致自杀在数月和季节间分布不均。在对奥地利监狱系统自杀情况的全面调查中,研究了1947年至1999年间监禁自杀的每周、每月和季节性分布。通过卡方检验对一年中工作日、月份和季节的自杀分布进行探索性比较后,进行了调和泊松回归模型以检测自杀的季节性。在这53年期间,自杀没有明显的分布不均。这项研究的一个局限性是其样本量为412,与基于人群的样本相比数量较少,而基于人群的样本中一直发现春季自杀高峰。缺乏季节性的一个解释可能是,生物气候因素在监狱通常所在的城市工业化地区不太相关。刑罚机构的核心特征之一是交流和社会互动的可能性有限。这种社会隔离与季节变化无关。如果个人的社会互动可能性有限,社会活动季节性变化的影响可能就不那么重要。这可以解释监禁自杀发生率不存在季节性变化的原因。