McNamee J E, Offord D R
Department of Psychiatry, McMaster University, Hamilton, Ont.
CMAJ. 1990 Jun 1;142(11):1223-30.
We reviewed the epidemiologic features of suicide in Canada and evaluated suicide prevention programs. Three groups were found to be at increased risk for suicide: men aged 70 years or more, women aged 65 to 69 and men aged 20 to 24. The other groups, in decreasing order of risk, were the mentally ill, people who have attempted suicide, those with a life-threatening illness, native people, people with a family history of suicide and prisoners. Studies that evaluated suicide prevention programs showed that none significantly reduced the incidence of suicide; however, the studies were found to be methodologically inadequate or used noncomparable systems of data collection. On the basis of our findings we recommend that primary care physicians routinely evaluate suicide risk among patients in high-risk groups and that intervention include counselling, follow-up and, if necessary, referral to a psychiatrist. Close follow-up is recommended for newly discharged psychiatric patients and those who recently attempted suicide.
我们回顾了加拿大自杀的流行病学特征，并评估了自杀预防项目。发现有三类人群自杀风险增加：70岁及以上男性、65至69岁女性以及20至24岁男性。其他风险依次降低的群体为：精神疾病患者、有过自杀未遂经历的人、患有危及生命疾病的人、原住民、有自杀家族史的人以及囚犯。评估自杀预防项目的研究表明，没有一个项目能显著降低自杀发生率；然而，这些研究在方法上存在不足，或者使用了不可比的数据收集系统。基于我们的研究结果，我们建议初级保健医生常规评估高危群体患者的自杀风险，干预措施应包括咨询、随访，必要时转诊至精神科医生。建议对新出院的精神科患者和近期有过自杀未遂经历的人进行密切随访。
