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1999年至2005年间匈牙利巴奇-基什孔州和基什孔哈拉斯地区60岁以上老年人群中自杀与抗抑郁药物消费(N06A)之间的关系

[Relationship between suicide and antidepressant consumption (N06A) in an elderly population (over 60 years) from Bács-Kiskun county and the Kiskunhalas region in Hungary between 1999 and 2005].

作者信息

Sándor Kalmár

机构信息

Semmelweis Korhaz KHT, Kiskunhalas, Hungary.

出版信息

Psychiatr Hung. 2007;22(6):430-42.

Abstract

INTRODUCTION

Although the number of suicides has been decreasing significantly in Hungary since 1983, it is still at a very high level. In spite of the general decrease in statistical figures, between 2004 and 2005 the number of male suicide victims increased in 8 counties and in 3 regions, while the number of female suicide victims increased in 4 counties. There are several new hypotheses to explain the decrease, among which, the most controversial is the one looking for connections between the decreasing number of suicide victims and the increasing consumption of antidepressants (N06A).

METHODOLOGY

Between 1999 and 2005, the relationship between suicides and antidepressant consumption was examined and analyzed in the 60+ population, coming from the Kiskunhalas, Kiskunmajsa and Jánoshalma small regions, the service area of the psychiatric ward of Kiskunhalas Hospital, from Bács-Kiskun County and from Hungary. These data were compared with those of the small region of Kiskunfélegyháza, which was the control area of the Kiskunhalas suicide prevention programme. Four indicators were used in the analysis of antidepressant consumption and suicides: 1. The number of patients using antidepressants. 2. The days of treatment; DOT. 3. The amount of the antidepressant used. 4. DHD: DDD/1000 inhabitant/day. (DDD: Defined daily dose by the WHO). Considering the fact that depressive states mixed with anxiety increase the risk of suicide, the connections between the number of suicides and the use of anxiety drugs were also analyzed. The connections were identified with correlation coefficients.

RESULTS

The results of the analysis supported the hypothesis that despite some contradictions, there is a connection between the increase in antidepressant use and the decrease in the number of suicides.

CONCLUSIONS

First, the complex diagnostics and treatment of depression has led to the decrease in suicidal risk in depressed patients. Second: more attention must be paid to anxiety disorders. Third: in the forthcoming suicide prevention programmes, greater attention must be paid to the 60+ population. Fourth: there is an underlying question which remains to be explained by future research: considering the fact that depressive disorders can be treated, why cannot this lead to a sharper decrease in the number of suicides?

摘要

引言

尽管自1983年以来匈牙利的自杀人数显著下降,但仍处于非常高的水平。尽管统计数据总体呈下降趋势,但在2004年至2005年间,8个县和3个地区的男性自杀受害者人数增加,4个县的女性自杀受害者人数增加。有几种新的假说来解释这种下降,其中最具争议的是寻找自杀受害者人数减少与抗抑郁药(N06A)消费量增加之间的联系。

方法

1999年至2005年间,对来自基什孔哈拉斯、基什孔马伊萨和亚诺什哈尔马小地区(基什孔哈拉斯医院精神科病房的服务区域)、巴奇-基什孔县以及匈牙利的60岁及以上人群中自杀与抗抑郁药消费之间的关系进行了研究和分析。这些数据与基什孔费莱吉哈扎小地区的数据进行了比较,该地区是基什孔哈拉斯自杀预防项目的对照区域。在分析抗抑郁药消费和自杀情况时使用了四个指标:1. 使用抗抑郁药的患者人数。2. 治疗天数;DOT。3. 使用的抗抑郁药数量。4. DHD:DDD/1000居民/天。(DDD:世界卫生组织定义的每日限定剂量)。考虑到混合焦虑的抑郁状态会增加自杀风险,还分析了自杀人数与抗焦虑药物使用之间的联系。这些联系通过相关系数来确定。

结果

分析结果支持了这样一种假设,即尽管存在一些矛盾之处,但抗抑郁药使用的增加与自杀人数减少之间存在联系。

结论

第一,对抑郁症的综合诊断和治疗导致了抑郁症患者自杀风险的降低。第二:必须更加关注焦虑症。第三:在即将开展的自杀预防项目中,必须更加关注60岁及以上人群。第四:有一个潜在问题有待未来研究来解释:鉴于抑郁症可以得到治疗,为什么自杀人数不能更显著地下降?

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