Norwegian Centre for Addiction Research, University of Oslo, Norway.
Am J Epidemiol. 2010 Jul 15;172(2):160-6. doi: 10.1093/aje/kwq091. Epub 2010 Jun 2.
Studies of clinical cohorts and retrospective reports have identified psychiatric disorders as paramount risk factors for suicide. Much less is known about how self-reported mental health is related to completed suicide. To study the relation between self-reported mental health and risk of completed suicide, the authors prospectively followed a population-based Norwegian cohort of 61,588 men and 69,774 women aged 39-44 years for an average of 10.4 years between 1994 and 2007. Self-reported mental health was measured using an instrument based on the Hopkins Symptom Checklist and the General Health Questionnaire. Completed suicides were registered in the official Norwegian Cause of Death Registry. Females reported higher levels of mental distress than males. In comparison with persons reporting the fewest mental health symptoms, the adjusted hazard ratio for suicide increased from 1.8 (95% confidence interval (CI): 1.1, 2.9) in the moderately depressed group to 8.9 (95% CI: 4.4, 18.2) in the most depressed group. The risk difference was greatest in males. At each level of the mental health index, males had double the risk of suicide of females (hazard ratio = 2.3, 95% CI: 1.5, 3.3). This study shows a dose-response effect of self-reported mental health problems on completed suicide and replicates the gender paradox observed in the general population with prospective data.
研究表明，精神障碍是自杀的首要危险因素，其主要来自临床队列研究和回顾性报告。然而，自我报告的心理健康状况与自杀完成之间的关系则知之甚少。为了研究自我报告的心理健康状况与自杀完成风险之间的关系，作者前瞻性地随访了一个基于人群的挪威队列，该队列由 61588 名 39-44 岁的男性和 69774 名女性组成，随访时间平均为 10.4 年，随访时间为 1994 年至 2007 年。自我报告的心理健康状况使用基于 Hopkins 症状清单和一般健康问卷的工具进行测量。自杀完成情况在官方挪威死因登记处登记。女性报告的精神困扰水平高于男性。与报告精神健康症状最少的人相比，中度抑郁组自杀的调整后危害比从 1.8（95%置信区间[CI]：1.1，2.9）增加到最抑郁组的 8.9（95%CI：4.4，18.2）。男性的风险差异最大。在心理健康指数的每个水平上，男性自杀的风险是女性的两倍（危害比=2.3，95%CI：1.5，3.3）。这项研究显示了自我报告的心理健康问题与自杀完成之间存在剂量反应关系，并通过前瞻性数据复制了在一般人群中观察到的性别悖论。
