Department of Psychological Medicine, Faculty of Medicine, University of Colombo, 25 Kynsey Road, Colombo 08, Sri Lanka.
Bull World Health Organ. 2012 Jan 1;90(1):40-6. doi: 10.2471/BLT.11.091785. Epub 2011 Oct 4.
To explore if recent changes in methods of self-harm in Sri Lanka could explain the decline in the incidence of suicide.
Time series analyses of suicide rates and hospitalization due to different types of poisoning were carried out.
Between 1996 and 2008 the annual incidence of hospital admission resulting from poisoning by medicinal or biological substances increased exponentially, from 48.2 to 115.4 admissions per 100,000 population. Over the same period, annual admissions resulting from poisoning with pesticides decreased from 105.1 to 88.9 per 100,000. The annual incidence of suicide decreased exponentially, from a peak of 47.0 per 100,000 in 1995 to 19.6 per 100,000 in 2009. Poisoning accounted for 37.4 suicides per 100,000 population in 1995 but only 11.2 suicides per 100,000 in 2009. The case fatality rate for pesticide poisoning decreased linearly, from 11.0 deaths per 100 cases admitted to hospital in 1997 to 5.1 per 100 in 2008.
Since the mid 1990s, a trend away from the misuse of pesticides (despite no reduction in pesticide availability) and towards increased use of medicinal and other substances has been seen in Sri Lanka among those seeking self-harm. These trends and a reduction in mortality among those suffering pesticide poisoning have resulted in an overall reduction in the national incidence of accomplished suicide.
探讨斯里兰卡自残方式的近期变化是否可以解释自杀率的下降。
对自杀率和不同类型中毒住院的时间序列进行分析。
1996 年至 2008 年间，因药用或生物物质中毒住院的人数呈指数增长，从每 10 万人 48.2 例增加到 115.4 例。同期，因农药中毒的年住院人数从每 10 万人 105.1 例降至 88.9 例。自杀的年发生率呈指数下降，从 1995 年每 10 万人 47.0 例的峰值降至 2009 年的 19.6 例。1995 年，中毒导致每 10 万人中有 37.4 人自杀，但 2009 年这一比例降至每 10 万人中有 11.2 人自杀。农药中毒的病死率呈线性下降，从 1997 年每 100 例住院病例死亡 11.0 例降至 2008 年的 5.1 例。
自 20 世纪 90 年代中期以来，斯里兰卡寻求自残的人群中，出现了从滥用农药（尽管农药供应没有减少）转向更多使用药用和其他物质的趋势。这些趋势以及农药中毒患者死亡率的降低，导致全国自杀未遂发生率总体下降。
