Simon Gregory E, Hunkeler Enid, Fireman Bruce, Lee Janelle Y, Savarino James
Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA.
Bipolar Disord. 2007 Aug;9(5):526-30. doi: 10.1111/j.1399-5618.2007.00408.x.
To evaluate demographic and clinical predictors of suicide attempt and suicide death in a population-based sample of people treated for bipolar disorder (BD).
Computerized records were used to identify 32,360 individuals treated for BD at two large prepaid health plans. Suicide attempts were identified using computerized records of outpatient visit diagnoses and hospital discharge diagnoses. Suicide deaths were identified using state death certificate data.
Overall event rates were 1.06 per 1,000 person-years for suicide death, 5.6 per 1,000 person-years for suicide attempt leading to hospitalization, and 13.9 per 1,000 person-years for suicide attempt not leading to hospitalization. Men had a significantly lower rate of suicide attempt [hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.56-0.83] but a higher rate of suicide death (HR 2.70, 95% CI 1.69-4.31). Suicide attempts were significantly more frequent among younger patients, but suicide deaths did not vary significantly by age. Substance use comorbidity was significantly related to risk of suicide attempt (HR 2.53, 95% CI 2.07-3.09) but not to risk of suicide death (HR 1.02, 95% CI 0.54-1.93). Comorbid anxiety disorder was associated with significantly higher risk of both suicide attempt (HR 1.40, 95% CI 1.14-1.72) and suicide death (HR 1.81, 95% CI 1.09-2.99).
Among people treated for BD, risk of suicide death is significantly related to male sex and comorbid anxiety disorder. The predictors of suicide death differ markedly from predictors of suicide attempt.
在以人群为基础的双相情感障碍（BD）治疗样本中，评估自杀未遂和自杀死亡的人口统计学及临床预测因素。
利用计算机化记录，在两个大型预付健康计划中识别出32360名接受BD治疗的个体。自杀未遂通过门诊就诊诊断和医院出院诊断的计算机化记录来识别。自杀死亡通过州死亡证明数据来识别。
自杀死亡的总体发生率为每1000人年1.06例，导致住院的自杀未遂发生率为每1000人年5.6例，未导致住院的自杀未遂发生率为每1000人年13.9例。男性自杀未遂发生率显著较低[风险比（HR）0.68，95%置信区间（CI）0.56 - 0.83]，但自杀死亡率较高（HR 2.70，95% CI 1.69 - 4.31）。年轻患者中自杀未遂明显更频繁，但自杀死亡在各年龄组中差异不显著。物质使用合并症与自杀未遂风险显著相关（HR 2.53，95% CI 2.07 - 3.09），但与自杀死亡风险无关（HR 1.02，95% CI 0.54 - 1.93）。合并焦虑症与自杀未遂（HR 1.40，95% CI 1.14 - 1.72）和自杀死亡（HR 1.81，95% CI 1.
