Scocco Paolo, de Girolamo Giovanni, Vilagut Gemma, Alonso Jordi
Department of Mental Health, Azienda-ULSS 16, 35100 Padua, Italy.
Compr Psychiatry. 2008 Jan-Feb;49(1):13-21. doi: 10.1016/j.comppsych.2007.08.004.
As in other Mediterranean countries, suicide mortality rates in Italy are generally lower than they are in Northern and Central European countries and on other continents (eg, North America, Australia). Yet, no studies to date have examined the prevalence of and risk factors for suicide ideation, plans, and attempts, in the general population in Italy.
Suicide ideation, plans, and attempts and potential risk factors were assessed in a community survey conducted with 4712 adult respondents (response rate, 71.2%). The participants had been selected from Italian municipality resident registries and made up a stratified, multistage, clustered probability sample. The project was part of the World Health Organization World Mental Health (WMH) Survey Initiative.
The lifetime prevalence (SE) of suicide ideation, plans, and attempts was 3.0% (0.3), 0.7% (0.1), and 0.5% (0.1), respectively. Prevalence rates of these suicide-related phenomena did not differ by Italian geographic macro-area (Northern, Central, and Southern Italy, including the islands of Sicily and Sardinia). Among ideators, the probability of ever making a plan was 24.6% (4.0) and attempt was 18.2% (4.5). The probability of making an attempt for ideators having made a suicide plan was nearly 50%. Risk factors for lifetime suicide-related phenomena were female sex, younger cohort, fewer years of education, and earlier onset age of suicide ideation. The presence of a common mental disorder, especially if comorbid, was associated with a significantly increased risk for all suicide phenomena investigated (ideation, plans, and attempts suicide). There were no substantial differences in the frequency of these phenomena among the 3 main macro-areas examined, that is, Northern, Central, and Southern Italy (including Sicily and Sardinia), which conversely show marked climate, socioeconomic, and cultural differences.
As shown in previous studies examining suicide, suicide continuum phenomena (in terms of ideation, plans, and attempt) in Italy were lower than typically observed for other European countries and did not differ for different macro-areas presenting remarkably different socioeconomic conditions. Prevalence rates of common mental disorders were equally lower in Italy than in other European countries. Although the detection of mental disorders represents an important step in suicide prevention, the correlations observed between various suicidal continuum manifestations suggest that timely recognition of suicide ideation and plans is an equally crucial factor in the implementation of effective preventive policies.
与其他地中海国家一样，意大利的自杀死亡率总体低于北欧和中欧国家以及其他大陆（如北美、澳大利亚）。然而，迄今为止尚无研究调查意大利普通人群中自杀意念、计划和未遂行为的患病率及风险因素。
在一项对4712名成年受访者进行的社区调查中评估了自杀意念、计划和未遂行为以及潜在风险因素（应答率为71.2%）。参与者从意大利各市镇居民登记册中选取，构成一个分层、多阶段、整群概率样本。该项目是世界卫生组织世界心理健康（WMH）调查倡议的一部分。
自杀意念、计划和未遂行为的终生患病率（标准误）分别为3.0%（0.3）、0.7%（0.1）和0.5%（0.1）。这些与自杀相关现象的患病率在意大利不同地理大区（意大利北部、中部和南部，包括西西里岛和撒丁岛）之间没有差异。在有自杀意念者中，曾制定计划的概率为24.6%（4.0），曾尝试自杀的概率为18.2%（4.5）。有自杀计划的意念者尝试自杀的概率近50%。终生自杀相关现象的风险因素包括女性、较年轻的年龄组、受教育年限较少以及自杀意念的发病年龄较早。存在常见精神障碍，尤其是合并存在时，与所有调查的自杀现象（意念、计划和自杀未遂）的风险显著增加相关。在所调查的3个主要大区，即意大利北部、中部和南部（包括西西里岛和撒丁岛），这些现象的发生频率没有实质性差异，而这些大区在气候、社会经济和文化方面存在显著差异。
如先前关于自杀的研究所显示，意大利的自杀连续体现象（在意念、计划和未遂方面）低于其他欧洲国家的典型情况，并且在社会经济状况差异显著的不同大区之间没有差异。意大利常见精神障碍患病率同样低于其他欧洲国家。虽然发现精神障碍是预防自杀的重要一步，但各种自杀连续体表现之间观察到的相关性表明，及时识别自杀意念和计划是实施有效预防政策的同样关键的因素。
