Karvonen Kaisa, Sammela Hanna-Lena, Rahikkala Heidi, Hakko Helinä, Särkioja Terttu, Meyer-Rochow V Benno, Räsänen Pirkko, Timonen Markku
Department of Psychiatry, University of Oulu, 90014 Oulu, Finland.
Compr Psychiatry. 2007 Jul-Aug;48(4):319-22. doi: 10.1016/j.comppsych.2007.02.004. Epub 2007 Mar 29.
Schizophrenia and depression by themselves and especially in combination with each other are known to be important risk factors of suicide. An increased risk of suicide has also been reported for the period immediately after a psychiatric patient's discharge from the hospital. However, to the best of our knowledge, it remains unknown whether survival times differ between suicide victims with schizophrenia concomitantly with and those without depression.
This study aimed to examine survival times from the discharge of last hospital treatment (irrespective of the kind of illness) to the day of death in suicide victims with schizophrenia with or without concomitant depression.
A 16-year database of all suicides (1535 males, 342 females) committed during the years 1988-2003 in the province of Oulu in northern Finland, and information available from the national hospital discharge registers formed the basis of this study.
In male suicide victims with schizophrenia, the median survival time after final hospitalization was approximately 1 day in those with a history of depression and 90 days in those without depression (P = .005). The corresponding times for females were 50 and 24 days, respectively (P = .396). Using Cox regression analysis after adjusting for confounders, we noticed a statistically significant difference in survival times from last hospitalization to suicide between depressive and nondepressive male patients with schizophrenia (hazard ratio, 1.80; 95% confidence interval, 1.04-3.11), but not females (hazard ratio, 0.72; 95% confidence interval, 0.34-1.53).
Concomitant depression was markedly linked with shorter survival time in male suicide victims with schizophrenia after last hospitalization. Psychiatric inpatient facilities appear to be in a key position to establish suicide prevention programs for patients with schizophrenia, especially those with depression.
精神分裂症和抑郁症本身，尤其是两者并存时，已知是自杀的重要危险因素。据报道，精神病患者出院后的 immediately 期间自杀风险也会增加。然而，据我们所知，患有精神分裂症且伴有或不伴有抑郁症的自杀受害者的生存时间是否存在差异仍不清楚。
本研究旨在调查患有或不伴有抑郁症的精神分裂症自杀受害者从最后一次住院治疗出院（无论疾病类型）到死亡之日的生存时间。
以1988 - 2003年芬兰北部奥卢省所有自杀事件（1535名男性，342名女性）的16年数据库以及国家医院出院登记册中的可用信息为基础进行本研究。
在患有精神分裂症的男性自杀受害者中，有抑郁症病史的患者最后一次住院后的中位生存时间约为1天，无抑郁症病史的患者为90天（P = 0.005）。女性的相应时间分别为50天和24天（P = 0.396）。在对混杂因素进行调整后使用Cox回归分析，我们注意到患有精神分裂症的抑郁和非抑郁男性患者从最后一次住院到自杀的生存时间存在统计学上的显著差异（风险比，1.80；95%置信区间，1.04 - 3.11），但女性不存在差异（风险比，0.72；95%置信区间，0.34 - 1.53）。
在患有精神分裂症的男性自杀受害者中，并存的抑郁症与最后一次住院后的较短生存时间显著相关。精神病住院设施似乎在为精神分裂症患者，尤其是伴有抑郁症的患者建立自杀预防计划方面处于关键地位。
