Hunt Isabelle M, Kapur Navneet, Robinson Jo, Shaw Jenny, Flynn Sandra, Bailey Hayley, Meehan Janet, Bickley Harriet, Burns James, Appleby Louis, Parsons Rebecca
Centre for Suicide Prevention, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK.
Br J Psychiatry. 2006 Feb;188:135-42. doi: 10.1192/bjp.188.2.135.
Suicide prevention is a health service priority but the most effective approaches to prevention may differ between different patient groups.
To describe social and clinical characteristics in cases of suicide from different age and diagnostic groups.
A national clinical survey of a 4-year (1996-2000) sample of cases of suicide in England and Wales where there had been recent (<1 year) contact with mental health services (n=4859).
Deaths of young patients were characterised by jumping from a height or in front of a vehicle, schizophrenia, personality disorder, unemployment and substance misuse. In older patients, drowning, depression, living alone, physical illness, recent bereavement and suicide pacts were more common. People with schizophrenia were often in-patients and died by violent means. About a third of people with depressive disorder died within a year of illness onset. Those with substance dependence or personality disorder had high rates of disengagement from services.
Prevention measures likely to benefit young people include targeting schizophrenia, dual diagnosis and loss of service contact; those aimed at depression, isolation and physical ill-health should have more effect on elderly people.
预防自杀是卫生服务的重点，但不同患者群体中最有效的预防方法可能有所不同。
描述不同年龄和诊断组自杀案例的社会和临床特征。
对1996年至2000年期间在英格兰和威尔士有近期（<1年）与心理健康服务机构接触的自杀案例样本（n = 4859）进行全国性临床调查。
年轻患者的死亡特征为从高处跳下或在车辆前自杀、患有精神分裂症、人格障碍、失业和药物滥用。老年患者中，溺水、抑郁症、独居、身体疾病、近期丧亲之痛和自杀协议更为常见。精神分裂症患者通常是住院患者，死于暴力手段。约三分之一的抑郁症患者在发病一年内死亡。有药物依赖或人格障碍的患者脱离服务的比例很高。
可能使年轻人受益的预防措施包括针对精神分裂症、双重诊断和失去服务联系；针对抑郁症、孤独和身体不健康的措施对老年人的效果可能更大。
