Alaräisänen A, Miettunen J, Lauronen E, Räsänen P, Isohanni M
Department of Psychiatry, University of Oulu, Oulu, Finland.
Acta Psychiatr Scand. 2006 Nov;114(5):357-62. doi: 10.1111/j.1600-0447.2006.00800.x.
Our aim was to analyse the relationship between good school performance and risk of suicide in the Northern Finland 1966 Birth Cohort, especially in psychoses.
A total of 11,017 cohort members who were alive at the age of 16 years were followed up to the age of 35 years. School performance was measured by the school marks given at age 16 at the end of comprehensive school. School, diagnostic and mortality data were based on national registers.
For psychotic persons having good school performance (highest 20%), the adjusted hazard ratio (HR) for suicide was 3.56 (0.97-13.05) compared with the remaining 80%. In the non-psychotic population (97% without psychiatric hospitalization), accordingly, adjusted HR was 0.28 (0.07-1.16). Interaction (school performance x psychiatric diagnosis) was significant (P = 0.01) even when adjusted with gender, social class and age of onset of illness.
Good school performance at age 16 years is associated with increased risk of suicide (before age 35 years) in persons who develop psychosis, whereas in persons who do not develop psychosis, it is associated with lower suicide risk.
我们的目的是分析1966年芬兰北部出生队列中良好学业成绩与自杀风险之间的关系，尤其是在精神病患者中。
对16岁时仍在世的11017名队列成员进行随访，直至35岁。学业成绩通过综合学校16岁末时给出的学校成绩来衡量。学校、诊断和死亡率数据基于国家登记册。
学业成绩良好（最高20%）的精神病患者，与其余80%相比，自杀调整风险比（HR）为3.56（0.97 - 13.05）。在非精神病患者群体（97%无精神病住院史）中，相应地，调整HR为0.28（0.07 - 1.16）。即使在按性别、社会阶层和发病年龄进行调整后，交互作用（学业成绩×精神病诊断）仍具有显著性（P = 0.01）。
16岁时学业成绩良好与患精神病者（35岁前）自杀风险增加相关，而在未患精神病者中，则与较低自杀风险相关。
