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老年自杀的发生率及既往疾病史。

Rates and previous disease history in old age suicide.

作者信息

Koponen Hannu J, Viilo Kaisa, Hakko Helinä, Timonen Markku, Meyer-Rochow V Benno, Särkioja Terttu, Räsänen Pirkko

机构信息

Department of Psychiatry, University of Kuopio, Kuopio, Finland.

出版信息

Int J Geriatr Psychiatry. 2007 Jan;22(1):38-46. doi: 10.1002/gps.1651.

Abstract

OBJECTIVE

Suicide rates in persons over 65 have been reported to be higher than those of younger age groups. Since the absolute number of suicides in the elderly is expected to rise, more precise ways to identify potential risk factors for elderly suicides are needed.

METHODS

On the basis of forensic examinations suicide rates and methods in elderly Finns of northern Finland were compared with those of adults aged 18-64 years. Data from earlier illnesses of the suicide victims were scrutinized for records of multiple physical disorders.

RESULTS

Over the 15-year period the mean annual suicide rate per population of 100,000 was significantly lower in the elderly (22.5) than adults aged 18-64 years (38.4). A decrease in suicide rates over time occurred in both groups. Suicide methods among elderly were more often violent, and they were seldom under the influence of alcohol. They also had a high prevalence of previous hospital-treated depressive episodes and hospital-treated physical illnesses. A lifetime history of hospital-treated depression was more common among elderly victims who had received hospital treatment for genitourinary diseases, injuries or poisonings after their 50th birthday.

CONCLUSIONS

Our results from elderly suicide victims suggest an association between multiple physical illnesses and a history of depression. Especially, genitourinary diseases as well as hospital treatment due to injuries or poisonings were shown to associate with depression. Elderly Northern Finns showed lower suicide rates, and they decreased during the study period suggesting that active preventive measures against suicide are also feasible in the elderly.

摘要

目的

据报道,65岁以上人群的自杀率高于年轻年龄组。由于预计老年人自杀的绝对数量将会上升,因此需要更精确的方法来识别老年人自杀的潜在风险因素。

方法

基于法医检查,将芬兰北部老年芬兰人的自杀率和自杀方式与18 - 64岁成年人的进行比较。仔细审查自杀受害者既往疾病的数据,以查找多种躯体疾病的记录。

结果

在这15年期间,每10万人口的年平均自杀率在老年人中(22.5)显著低于18 - 64岁的成年人(38.4)。两组的自杀率均随时间下降。老年人的自杀方式更常为暴力方式,且很少受酒精影响。他们既往有住院治疗的抑郁发作和住院治疗的躯体疾病的患病率也很高。在50岁以后因泌尿生殖系统疾病、损伤或中毒接受过住院治疗的老年自杀受害者中,有住院治疗抑郁症终生史的更为常见。

结论

我们对老年自杀受害者的研究结果表明,多种躯体疾病与抑郁病史之间存在关联。特别是,泌尿生殖系统疾病以及因损伤或中毒而接受的住院治疗被证明与抑郁症有关。芬兰北部的老年人自杀率较低,且在研究期间有所下降,这表明针对老年人的积极自杀预防措施也是可行的。

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