Flensborg-Madsen Trine, Knop Joachim, Mortensen Erik Lykke, Becker Ulrik, Sher Leo, Grønbaek Morten
Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, and Department of Health Psychology, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
Psychiatry Res. 2009 May 15;167(1-2):123-30. doi: 10.1016/j.psychres.2008.01.008. Epub 2009 Apr 9.
Knowledge of the epidemiology of suicide is a necessary prerequisite for developing prevention programs. The aim of this study was to analyze the risk of completed suicide among individuals with alcohol use disorders (AUD), and to assess the role of other psychiatric disorders in this association. A prospective cohort study was used, containing three updated sets of lifestyle covariates and 26 years follow-up of 18,146 individuals between 20 and 93 years of age from the Copenhagen City Heart Study in Denmark. The study population was linked to four different registers in order to detect: Completed suicide, AUD, Psychotic disorders, Anxiety disorders, Mood disorders, Personality disorders, Drug abuse, and Other psychiatric disorders. Individuals registered with AUD were at significantly increased risk of committing suicide, with a crude hazard ratio (HR) of 7.98 [Confidence interval (CI): 5.27-12.07] compared to individuals without AUD. Adjusting for all psychiatric disorders the risk fell to 3.23 (CI: 1.96-5.33). In the stratified sub-sample of individuals without psychiatric disorders, the risk of completed suicide was 9.69 (CI: 4.88-19.25) among individuals with AUD. The results indicate that individuals registered with AUD are at highly increased risk of completed suicide, and that registered co-morbid psychiatric disorders are neither sufficient nor necessary causes in this association.
了解自杀流行病学是制定预防计划的必要前提。本研究的目的是分析酒精使用障碍(AUD)患者中自杀身亡的风险,并评估其他精神障碍在这种关联中的作用。采用前瞻性队列研究,纳入了丹麦哥本哈根市心脏研究中18146名年龄在20至93岁之间个体的三组更新的生活方式协变量,并进行了26年的随访。研究人群与四个不同的登记处相链接,以检测:自杀身亡、AUD、精神障碍、焦虑症、情绪障碍、人格障碍、药物滥用和其他精神障碍。与无AUD的个体相比,登记有AUD的个体自杀风险显著增加,粗危险比(HR)为7.98 [置信区间(CI):5.27 - 12.07]。在对所有精神障碍进行校正后,风险降至3.23(CI:1.96 - 5.33)。在无精神障碍个体的分层子样本中,有AUD的个体自杀身亡风险为9.69(CI:4.88 - 19.25)。结果表明,登记有AUD的个体自杀身亡风险大幅增加,并且登记的共病精神障碍在这种关联中既不是充分原因也不是必要原因。