Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
J Clin Psychiatry. 2011 Apr;72(4):487-93. doi: 10.4088/JCP.09m05360gry. Epub 2010 Sep 7.
Methamphetamine as a recreational drug has undergone cycles of popularity, with a recent surge worldwide since the 1990s. This study aimed to identify clinical characteristics associated with suicide mortality in patients with methamphetamine dependence by means of a nested case-control design.
In a consecutive series of 1,480 inpatients with methamphetamine dependence (diagnosed according to DSM-III-R and DSM-IV criteria) admitted to a psychiatric center in northern Taiwan from January 1, 1990, through December 31, 2006, 38 deaths due to suicide were identified as cases via record linkage, and 76 controls were randomly selected using risk-set density sampling in a 2:1 ratio, matched for age, sex, and the year of index admission. A standardized chart review process was adopted to collate sociodemographic and clinical information for each study subject. Multivariate conditional logistic regression analysis was used to identify correlates of suicide among these patients.
For the sociodemographic and symptom profiles at the latest admission, financial independence lowered the risk for suicide (adjusted risk ratio [ARR] = 0.33, P < .05), whereas visual hallucinations elevated the risk (ARR = 2.57, P < .05) for suicide. For the profiles during the postdischarge period, financial independence (ARR = 0.11, P < .05) remained associated with reduced risk for suicide, whereas suicide attempt (ARR = 8.78, P < .05) and depressive syndrome (ARR = 3.28, P = .059) were associated with increased risk of suicide.
Both protective and risk factors for suicide mortality were found among inpatients with methamphetamine dependence, and the findings have implications for clinical intervention and prevention.
作为一种娱乐性药物，冰毒经历了几轮流行，自 20 世纪 90 年代以来，在全球范围内再次出现激增。本研究通过巢式病例对照设计，旨在确定与冰毒依赖患者自杀死亡率相关的临床特征。
在台湾北部一家精神病中心，对 1990 年 1 月 1 日至 2006 年 12 月 31 日连续收治的 1480 例冰毒依赖住院患者（根据 DSM-III-R 和 DSM-IV 标准诊断）进行了一项研究，通过记录链接确定了 38 例自杀死亡病例，并采用风险集密度抽样以 2:1 的比例随机选择 76 名对照，按年龄、性别和入院年份匹配。采用标准化图表回顾过程，为每位研究对象整理社会人口统计学和临床信息。采用多变量条件逻辑回归分析，确定这些患者自杀的相关因素。
在最近一次入院时的社会人口统计学和症状特征方面，经济独立降低了自杀风险（调整后的风险比[ARR] = 0.33，P <.05），而幻视则增加了自杀风险（ARR = 2.57，P <.05）。在出院后期间的特征方面，经济独立（ARR = 0.11，P <.05）仍然与自杀风险降低相关，而自杀企图（ARR = 8.78，P <.05）和抑郁综合征（ARR = 3.28，P =.059）与自杀风险增加相关。
在冰毒依赖住院患者中发现了自杀死亡率的保护和风险因素，这些发现对临床干预和预防具有重要意义。
