Lodhi Lubbaba Mahmood, Shah Ajit
Ealing Site, West London Mental Health NHS Trust, London.
Med Sci Law. 2005 Jan;45(1):31-8. doi: 10.1258/rsmmsl.45.1.31.
Elderly suicide rates have declined in recent years in several countries including England and Wales. This study examined the association between a trend of decline in age-specific suicide rates in the elderly in England and Wales and changes in various health and social factors for the period 1985 to 1998. Data on age-specific suicide rates was ascertained from the annual mortality statistics for the years 1985 to 1998. Data on the various health and social variables was ascertained from both the Statistics Division at the Department of Health and the Health and Personal Social Services Statistics, the yearly publications of the Department of Health from 1985 to 1998. The main findings of this study were (i) a significant negative correlation between the number of general practitioners and all categories of whole-time-equivalent (WTE) hospital medical staff and suicide rates for each of the four five-year age bands for males and females after the age of 65; (ii) a significant negative correlation between the number of new outpatient appointments for mental illness and suicide rates in males and females for each of the four five-year age bands between the ages 65-85 years; (iii) a significant positive correlation between the average daily number of available beds for mental illness and elderly suicide rates, for all five-year age bands between the ages 65-85 years; (iv) a significant negative correlation between the number of field social work staff and day centre staff and elderly suicide rates for each of the four five-year age bands after the age of 65 for males and females; and, (v) a significant positive correlation between the total number of elderly in all residential homes and the number of elderly in local authority residential homes and elderly suicide rates for each of the four five-year age bands between the ages 65-85 years for males and females. A trend of decline in age-specific suicide rates in the elderly in England and Wales from 1985 to 1998 was significantly associated with changes in various health and social variables. These included the number of general practitioners and hospital medical staff, the hospital psychiatric services, the number of local authority staff and the number of elderly residents in accommodation supported by a local authority. The results of this study suggest that changes in these variables may be important factors contributing to the recent decline in suicide rates but this effect should be viewed in the context of other health and social factors.
近年来，包括英格兰和威尔士在内的几个国家的老年人自杀率有所下降。本研究调查了1985年至1998年期间，英格兰和威尔士老年人特定年龄自杀率下降趋势与各种健康和社会因素变化之间的关联。特定年龄自杀率的数据来自1985年至1998年的年度死亡率统计数据。各种健康和社会变量的数据来自卫生部统计司以及健康与个人社会服务统计数据，即卫生部1985年至1998年的年度出版物。本研究的主要发现如下：（i）65岁及以上男性和女性的四个五年年龄组中，全科医生数量以及所有全职等效（WTE）医院医务人员数量与自杀率之间存在显著负相关；（ii）65至85岁的四个五年年龄组中，男性和女性的精神疾病新门诊预约数量与自杀率之间存在显著负相关；（iii）65至85岁的所有五年年龄组中，精神疾病可用病床的平均每日数量与老年人自杀率之间存在显著正相关；（iv）65岁及以上男性和女性的四个五年年龄组中，实地社会工作者和日间护理中心工作人员数量与老年人自杀率之间存在显著负相关；（v）65至85岁的四个五年年龄组中，男性和女性的所有养老院老年人总数以及地方当局养老院老年人数量与老年人自杀率之间存在显著正相关。1985年至1998年期间，英格兰和威尔士老年人特定年龄自杀率的下降趋势与各种健康和社会变量的变化显著相关。这些变量包括全科医生和医院医务人员数量、医院精神科服务、地方当局工作人员数量以及由地方当局支持的住所中的老年居民数量。本研究结果表明，这些变量的变化可能是导致近期自杀率下降的重要因素，但这种影响应结合其他健康和社会因素来考虑。
