Centre for Mental Health and Risk, Institute of Brain, Behaviour & Mental Health, University of Manchester, UK.
J Affect Disord. 2013 Sep 5;150(2):237-44. doi: 10.1016/j.jad.2013.04.001. Epub 2013 May 9.
Gaining a greater knowledge of the mechanisms and means by which violent offenders die by suicide can inform tailored preventive strategies.
Using interlinked national Danish registry data we constructed a nested case-control study dataset of all adult suicides during 1994-2006: N=9708 cases and N=188,134 age and gender matched living controls. Completely ascertained International Classification of Diseases 10th revision cause-specific mortality codes were examined, with all criminal charges since 1980, and covariate information on psychiatric treatment and socio-demographics. Self-poisonings were classified as 'nonviolent' suicide and all other methods as being 'violent' ones.
Compared with the general population, risk among male and female violent offenders was strongly and significantly elevated for suicide by either a violent or a nonviolent method, although the relative risk was greater for nonviolent suicide. These patterns were also observed among nonviolent offenders, albeit with smaller effect sizes. Risk was especially raised for self-poisoning with narcotics & hallucinogens. We could only examine the full range of suicide methods in male violent offenders. In these men, hanging was the most frequently used method, although risk was markedly and significantly elevated virtually across the entire range of regularly used suicide methods.
We lacked sufficient statistical power for undertaking a detailed profiling of specific suicide methods among female violent offenders.
Our findings indicate that comprehensive and broadly-based preventive approaches are needed for tackling the markedly raised risk of suicide by both violent and nonviolent means in this population. Their high relative risk for self-poisoning by illicit or illegal drugs underlines the importance of access to means and of prevailing subculture.
深入了解暴力犯罪者自杀的机制和手段，可以为有针对性的预防策略提供信息。
利用丹麦国家间相互关联的登记数据，我们构建了一个嵌套病例对照研究数据集，其中包括 1994 年至 2006 年期间所有成年人自杀的病例：n=9708 例，n=188134 例年龄和性别匹配的存活对照。我们检查了完全确定的国际疾病分类第 10 次修订版的特定死因死亡率代码，包括自 1980 年以来的所有刑事指控，以及关于精神科治疗和社会人口统计学的协变量信息。自我中毒被归类为“非暴力”自杀，所有其他方法均归类为“暴力”自杀。
与一般人群相比，男性和女性暴力犯罪者自杀的风险通过暴力或非暴力手段均显著升高，尽管非暴力自杀的相对风险更高。在非暴力犯罪者中也观察到了这种模式，尽管效应大小较小。风险特别增加了使用麻醉剂和迷幻剂进行自我中毒的情况。我们只能在男性暴力犯罪者中检查所有自杀方法的完整范围。在这些男性中，上吊是最常用的方法，尽管几乎在所有常用的自杀方法中，风险都明显显著升高。
我们缺乏足够的统计能力来详细分析女性暴力犯罪者中特定自杀方法的情况。
我们的发现表明，需要采取全面和广泛的预防措施，以解决该人群中暴力和非暴力手段自杀风险明显升高的问题。他们使用非法或非法药物进行自我中毒的相对风险较高，突显了获得手段和普遍亚文化的重要性。
