Soeda Shuji, Nakamura Jun, Takahashi Norito, Kanazawa Kosuke, Shinkai Takahiro
Department of Psychiatry, Kyushu Rosai Hospital.
Seishin Shinkeigaku Zasshi. 2003;105(10):1254-64.
To investigate suicide among psychiatric patients in Japan (mainly Fukuoka prefecture), a questionnaire survey was submitted to psychiatrists from departments of psychiatry of university hospitals in Japan, departments of psychiatry of Rosai Hospitals in Japan, psychiatric hospitals in Fukuoka prefecture, psychiatric clinics in Fukuoka prefecture, and departments of psychiatry of general hospitals in Fukuoka prefecture regarding their psychiatric patients who died from suicide (266 females and 267 males). A large proportion of the patients at completed suicide was aged within the thirties to fifties. The majority of patients suffered from either F3 (mood disorders) or F2 (schizophrenia, schizotypal and delusional disorders) categories of the ICD-10 classification. Approximately one-fifth of the patients in Fukuoka prefecture had jobs at the time of completed suicide. The main "occupational risk factors" that were found to be risks for suicide were "failure or overloaded responsibilities in their jobs" and "worsening business situation". The main "other risk factors", i.e., risk factors other than "occupational risk factors" were "worsening psychiatric conditions", "personal life events (e.g., somatic illness or marital discord)" and "life events in other family members (e.g., familial discord or familial problems)". Over 50% of all cases had both "occupational risk factors" and "other risk factors", suggestive of the necessity for multidimensional evaluation and care in the treatment of suicidal patients. Given that numerous males that suffer from psychiatric disorders commit suicide without seeing a psychiatrist, it is important to establish a system to treat them appropriately in order to prevent unnecessary deaths.
为调查日本（主要是福冈县）精神病患者的自杀情况，我们向日本大学医院精神科、日本罗赛医院精神科、福冈县精神病医院、福冈县精神科诊所及福冈县综合医院精神科的精神科医生发放了关于其因自杀死亡的精神病患者（266名女性和267名男性）的问卷调查。自杀身亡的患者中很大一部分年龄在三十多岁到五十多岁之间。大多数患者患有国际疾病分类第十版（ICD - 10）中的F3（心境障碍）或F2（精神分裂症、分裂型障碍和妄想性障碍）类别。福冈县约五分之一的患者在自杀身亡时仍有工作。被发现为自杀风险因素的主要“职业风险因素”是“工作失败或责任过重”以及“业务状况恶化”。主要的“其他风险因素”，即除“职业风险因素”之外的风险因素，是“精神状况恶化”、“个人生活事件（如躯体疾病或婚姻不和）”以及“其他家庭成员的生活事件（如家庭不和或家庭问题）”。超过50%的病例同时存在“职业风险因素”和“其他风险因素”，这表明在治疗自杀患者时进行多维度评估和护理的必要性。鉴于众多患有精神疾病的男性在未看精神科医生的情况下自杀，建立一个适当治疗他们的系统以防止不必要的死亡非常重要。
