Nicoli M, Bouchez S, Nieto I, Gasquet I, Kovess V, Lépine J-P
Service de psychiatrie, hôpital Lariboisière-Fernand-Widal, Paris, France.
Encephale. 2012 Sep;38(4):296-303. doi: 10.1016/j.encep.2011.02.006. Epub 2011 Aug 10.
Suicide is a public health problem worldwide. The objective of this study is to analyse the prevalence and risk factors of suicide related outcomes (ideation, plan and attempt) using data from the ESEMeD-France project.
This is a face-to-face household survey carried out in a probability representative sample of the adult general population of France. A total of 6796 subjects were interviewed using the Composite International Diagnostic Interview (CIDI) developed framework of the World Mental Health Survey Initiative. Based on evidence that reports of such potentially embarrassing behaviour are higher in self-administered than interviewer-administered surveys, these questions were printed in a self-administered booklet and referred to by letter.
Lifetime prevalence of suicide ideation, plan and attempts were 12.4, 4.4 and 3.4% respectively. Risk of suicide-related outcomes was significantly higher among women and younger cohorts. Having a mental disorder was associated with an increased risk, especially in the case of psychiatric comorbidity. Mental disorders that are associated with an increase in suicidal attempts are anxiety disorders (except social phobia), major depressive episodes, oppositional defiant disorders, and attention deficit hyperactivity disorders. The suicidal risk notably increases in conjunction with multiple mental disorders. In this study, employment and marital status do not appear to be a risk factor for suicidal behaviour.
The prevalence of suicide-related outcomes is high when compared with other countries. Results identified groups with higher risk (women, young, subjects with a mental disorder and having a plan) in which suicide prevention could to be targeted. The results of this study suggest that to improve suicide prevention strategies it is necessary to perform an in-depth clinical evaluation of suicidal ideas and projects, and identify precisely psychiatric comorbidity to allow a more efficient treatment.
自杀是一个全球性的公共卫生问题。本研究的目的是利用法国ESEMeD项目的数据，分析自杀相关结局（意念、计划和未遂）的患病率及危险因素。
这是一项针对法国成年普通人群概率代表性样本进行的面对面家庭调查。共6796名受试者接受了基于世界心理健康调查倡议制定框架的复合国际诊断访谈（CIDI）。鉴于自我管理式调查中此类潜在尴尬行为的报告高于访谈员管理式调查，这些问题印在一本自我管理式小册子中，并通过字母指代。
自杀意念、计划和未遂的终生患病率分别为12.4%、4.4%和3.4%。自杀相关结局的风险在女性和较年轻队列中显著更高。患有精神障碍会增加风险，尤其是在存在精神疾病共病的情况下。与自杀未遂增加相关的精神障碍包括焦虑症（社交恐惧症除外）、重度抑郁发作、对立违抗障碍和注意力缺陷多动障碍。多种精神障碍同时存在时，自杀风险显著增加。在本研究中，就业和婚姻状况似乎不是自杀行为的危险因素。
与其他国家相比，自杀相关结局的患病率较高。研究结果确定了自杀预防可针对的高风险群体（女性、年轻人、患有精神障碍且有计划者）。本研究结果表明，为改进自杀预防策略，有必要对自杀想法和计划进行深入临床评估，并精确识别精神疾病共病，以便进行更有效的治疗。
