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[荷兰自杀率下降,自杀方式改变]

[Decreasing incidence of suicide in the Netherlands, with changing methods].

作者信息

van Hemert Albert M, de Kruif Marjolijn

机构信息

Parnassia Bavo groep, Bureau 24-uurszorg, Den Haag, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2009;153:B384.

Abstract

OBJECTIVE

To determine time trends in the incidence of suicide mortality and in the methods used during the period 1970-2007, and to determine the resulting number of lost life years.

DESIGN

Retrospective dynamic cohort study in the Dutch population.

METHOD

Analyses were based on national register data (from the Statistics Netherlands) concerning suicide numbers and methods, and demographic characteristics of the population. Data were standardized for age and sex using the direct method, with the Dutch population of 2007 as a reference. Time trends were calculated using the Poisson regression model.

RESULTS

Since 1983 the standardized incidence of suicide decreased by 38% (95% confidence interval (95% CI): 36-40) from 14.8 per 100,000 in the peak year of 1983 to 8.3 per 100,000 in 2007. In the age group of 20-59 years the decrease was considerably stronger for women than for men, with rates of 47% (95% CI: 44-51) and 18% (95% CI: 14-22), respectively. The strongest decline was found in the group aged 60 years and over, with a decrease of 58% (95% CI: 55-60). There was a decrease in drowning as the suicide method, while the incidence of hanging increased. Over 43,000 life years were lost to suicide in the Netherlands in 2007. Of the total number of years lost, 82% occurred in the age group of 20 to 59 years.

CONCLUSION

The number of suicides in the Netherlands has declined substantially since 1983. Factors that may have contributed to this development remain unknown at present.

摘要

目的

确定1970 - 2007年期间自杀死亡率的时间趋势以及所使用的自杀方法,并确定由此导致的生命年损失数量。

设计

对荷兰人群进行回顾性动态队列研究。

方法

分析基于荷兰统计局的全国登记数据,内容涉及自杀人数、方法以及人口的人口统计学特征。使用直接法对年龄和性别进行标准化,以2007年的荷兰人口作为参考。采用泊松回归模型计算时间趋势。

结果

自1983年以来,自杀的标准化发病率下降了38%(95%置信区间(95%CI):36 - 40),从1983年的高峰期每10万人14.8例降至2007年的每10万人8.3例。在20 - 59岁年龄组中,女性的下降幅度明显大于男性,分别为47%(95%CI:44 - 51)和18%(95%CI:14 - 22)。60岁及以上年龄组的下降最为明显,下降了58%(95%CI:55 - 60)。作为自杀方法,溺水的发生率有所下降,而上吊的发生率上升。2007年荷兰因自杀损失了超过43000个生命年。在总损失年数中,82%发生在20至59岁年龄组。

结论

自1983年以来,荷兰的自杀人数大幅下降。目前尚不清楚促成这一发展的因素。

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