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老年人自杀率:跨国比较以及与性别和老年年龄组的关联

Elderly suicide rates: cross-national comparisons and association with sex and elderly age-bands.

作者信息

Shah Ajit, Bhat Ravi, McKenzie Sheena, Koen Chris

机构信息

West London Mental Health NHS Trust and Imperial College School of Medicine, London, United Kingdom.

出版信息

Med Sci Law. 2007 Jul;47(3):244-52. doi: 10.1258/rsmmsl.47.3.244.

Abstract

Suicide rates generally increase with age. Examination of cross-national variations in elderly suicide rates may allow the generation of aetiological hypotheses. Suicide rates for males and females in the age-bands 65-74 years and 75+ years were ascertained from the World Health Organisation website for all the listed countries. Cross-national variations were examined by segregating different countries into four quartiles of elderly suicide rates. Suicide rates between males and females and between the two age-bands were compared across different countries. The main findings were: (i) there is wide cross-national variation in elderly suicide rates; (ii) elderly suicide rates were the lowest in Caribbean, central American and Arabic countries, and the highest in central and eastern European, some oriental and some west European countries; (iii) suicide rates were higher in men compared to women for both the age-bands; and, (iv) suicide rates were higher in the age-band 75+ years compared to the age-band 65-74 years for males and females. Potential explanations for regional and cross-national variations in elderly suicide rates include cross-national differences in genetic and environmental factors, prevalence of mental illness in the elderly, life expectancy, socio-economic deprivation, social fragmentation, cultural factors, the availability of appropriate healthcare services, and public health initiatives to improve the detection and treatment of mental illness, mental health and suicide prevention.

摘要

自杀率通常随年龄增长而上升。对老年人自杀率的跨国差异进行研究,或许能催生病因学假说。从世界卫生组织网站获取了所有列出国家65至74岁以及75岁以上年龄段男性和女性的自杀率。通过将不同国家划分为老年人自杀率的四个四分位数来研究跨国差异。比较了不同国家男性与女性之间以及两个年龄段之间的自杀率。主要研究结果如下:(i)老年人自杀率存在广泛的跨国差异;(ii)加勒比地区、中美洲和阿拉伯国家的老年人自杀率最低,中东欧、一些东方国家和一些西欧国家的自杀率最高;(iii)两个年龄段男性的自杀率均高于女性;(iv)75岁以上年龄段男性和女性的自杀率均高于65至74岁年龄段。老年人自杀率的区域和跨国差异的潜在解释包括基因和环境因素的跨国差异、老年人精神疾病的患病率、预期寿命、社会经济剥夺、社会分裂、文化因素、适当医疗服务的可及性,以及改善精神疾病检测与治疗、心理健康和自杀预防的公共卫生举措。

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