Sinclair Julia M A, Harriss Louise, Baldwin David S, King Elizabeth A
Centre for Suicide Research, UK.
J Affect Disord. 2005 Jul;87(1):107-13. doi: 10.1016/j.jad.2005.03.001.
Depressive disorders are associated with a significant risk of suicide. Inpatient status and recent discharge from hospital have been identified as times of high risk of suicide within the course of illness.
A matched retrospective case control study of 127 patients with depression requiring inpatient care who died by suicide as inpatients or in the 12 months following discharge from hospital. Single and multivariable conditional logistic regression identified independent risk and protective factors for suicide.
A history of deliberate self harm is a significant risk factor for suicide in patients with depression (OR 6.96; 95% CI 3.41-14.19), as is living alone (OR 2.11; 95% CI 1.15-3.87) and paid employment (OR 2.80; 95% CI 1.48-5.32). Admission to hospital during social crisis is associated with a reduction in suicide risk (OR 0.43; 95% CI 0.24-0.75).
This is a retrospective case-control study, using clinical data not originally collected for research purposes.
General population risk factors for suicide are less predictive of suicide in patients with depression requiring inpatient treatment. Clinicians need to be aware of factors which increase or reduce the risk of suicide in this group.
抑郁症与显著的自杀风险相关。住院状态及近期出院被确定为疾病过程中自杀的高风险时期。
一项匹配的回顾性病例对照研究，研究对象为127例需要住院治疗的抑郁症患者，这些患者在住院期间或出院后的12个月内自杀身亡。单变量和多变量条件逻辑回归分析确定了自杀的独立风险因素和保护因素。
故意自我伤害史是抑郁症患者自杀的重要风险因素（比值比6.96；95%置信区间3.41 - 14.19），独居（比值比2.11；95%置信区间1.15 - 3.87）和有有偿工作（比值比2.80；95%置信区间1.48 - 5.32）也是如此。在社会危机期间入院与自杀风险降低相关（比值比0.43；95%置信区间0.24 - 0.75）。
这是一项回顾性病例对照研究，使用的是最初并非为研究目的而收集的临床数据。
一般人群的自杀风险因素对需要住院治疗的抑郁症患者自杀的预测性较低。临床医生需要了解该群体中增加或降低自杀风险的因素。
