Department of Psychiatry and Psychology Mayo Clinic Rochester, Rochester, MN 55905, USA.
Gen Hosp Psychiatry. 2011 Mar-Apr;33(2):191-6. doi: 10.1016/j.genhosppsych.2011.01.011. Epub 2011 Feb 26.
The aim of this study was to define whether specific patient demographic groups, diagnoses or other factors are associated with psychiatric inpatients reporting firearms access.
A retrospective medical records review study was conducted using information on access to firearms from electronic medical records for all patients 16 years and older admitted between July 2007 and May 2008 at the Mayo Clinic Psychiatric Hospital in Rochester, MN. Data were obtained only on patients providing authorization for record review. Data were analyzed using univariate and multivariate logistic regression analyses accounting for gender, diagnostic groups, comorbid substance use, history of suicide attempts and family history of suicide/suicide attempts.
Seventy-four percent (1169/1580) of patients provided research authorization. The ratio of men to women was identical in both research and nonresearch authorization groups. There were 14.6% of inpatients who reported firearms access. In univariate analysis, men were more likely (P<.0001) to report access than women, and a history of previous suicide attempt(s) was associated with decreased access (P=.02). Multiple logistic regression analyses controlling for other factors found females and patients with history of previous suicide attempt(s) less likely to report access, while patients with a family history of suicide or suicide attempts reported increased firearms access. Diagnostic groups were not associated with access on univariate or multiple logistic regression analyses.
Men and inpatients with a family history of suicide/suicide attempts were more likely to report firearms access. Clinicians should develop standardized systems of identification of firearms access and provide guidance on removal.
本研究旨在确定特定的患者人口统计学群体、诊断或其他因素是否与报告拥有枪支的精神科住院患者有关。
使用明尼苏达州罗切斯特市梅奥诊所精神病院 2007 年 7 月至 2008 年 5 月期间所有 16 岁及以上入院患者的电子病历中关于枪支使用情况的信息,进行了一项回顾性病历审查研究。仅获取了对记录审查提供授权的患者的数据。使用单变量和多变量逻辑回归分析,考虑到性别、诊断组、合并物质使用、自杀未遂史和自杀/自杀未遂家族史,对数据进行了分析。
74%(1169/1580)的患者提供了研究授权。在研究和非研究授权组中,男女比例相同。有 14.6%的住院患者报告拥有枪支。在单变量分析中,男性(P<.0001)比女性更有可能报告拥有枪支,而先前自杀未遂史与降低拥有枪支的可能性相关(P=.02)。控制其他因素的多变量逻辑回归分析发现,女性和有先前自杀未遂史的患者报告拥有枪支的可能性较低,而有自杀或自杀未遂家族史的患者报告拥有枪支的可能性增加。在单变量或多变量逻辑回归分析中,诊断组与拥有枪支无关。
男性和有自杀/自杀未遂家族史的住院患者更有可能报告拥有枪支。临床医生应制定识别枪支拥有情况的标准化系统,并提供有关枪支移除的指导。