EA 40-47 Université Versailles Saint-Quentin-en-Yvelines, Versailles F-7800, France.
BMC Fam Pract. 2013 May 24;14:68. doi: 10.1186/1471-2296-14-68.
Suicide is a major public health problem in young people. General Practitioners (GPs) play a central role in suicide prevention. However data about how physicians deal with suicidal youths are lacking. This study aims to compare young adult suicide attempters (from 18 to 39 years old) with older adults in a primary care setting.
A cross-sectional study was carried. All suicide attempts (N=270) reported to the French Sentinel surveillance System from 2009 to 2011 were considered. We conducted comparison of data on the last GP's consultation and GPs' management in the last three months between young adults and older adults.
In comparison with older adults, young adults consulted their GP less frequently in the month preceding the suicidal attempt (40.9 vs. 64.6%, p=.01). During the last consultation prior to the suicidal attempt, they expressed suicidal ideas less frequently (11.3 vs. 21.9%, p=.03). In the year preceding the suicidal attempt, GPs identified depression significantly less often (42.0 vs. 63.4%, p=.001). In the preceding three months, GPs realized significantly less interventions: less psychological support (37.5 vs. 53.0%, p=.02), prescribed less antidepressants (28.6 vs. 54.8%, p<.0001) or psychotropic drugs (39.1 vs. 52.9%, p=.03) and made fewer attempts to refer to a mental health specialist (33.3 vs. 45.5%, p=.05).
With young adults who subsequently attempt suicide, GPs face particular difficulties compared to older adults, as a significant proportion of young adults were not seen in the previous six months, as GPs identified less depressions in the preceding year and were less active in managing in the preceding three months. Medical training and continuing medical education should include better instruction on challenges relative to addressing suicide risk in this particular population.
自杀是年轻人面临的一个主要公共卫生问题。全科医生（GP）在预防自杀方面发挥着核心作用。然而，关于医生如何处理有自杀倾向的年轻人的数据却很缺乏。本研究旨在比较初级保健环境中年轻的成年自杀未遂者（18 至 39 岁）和老年患者。
进行了一项横断面研究。考虑了 2009 年至 2011 年向法国 Sentinel 监测系统报告的所有自杀未遂事件（N=270）。我们比较了年轻成年人和老年人在过去三个月中最后一次 GP 就诊时的数据和 GP 管理。
与老年患者相比，年轻患者在自杀企图前一个月就诊的频率较低（40.9%比 64.6%，p=.01）。在自杀企图前的最后一次就诊中，他们表达自杀想法的频率较低（11.3%比 21.9%，p=.03）。在自杀企图前一年，GP 明显较少识别出抑郁症（42.0%比 63.4%，p=.001）。在过去三个月中，GP 实施的干预措施明显较少：心理支持较少（37.5%比 53.0%，p=.02），开的抗抑郁药较少（28.6%比 54.8%，p<.0001）或精神药物较少（39.1%比 52.9%，p=.03），尝试转介给心理健康专家的次数也较少（33.3%比 45.5%，p=.05）。
与老年患者相比，随后自杀未遂的年轻患者给 GP 带来了特别的困难，因为很大一部分年轻患者在过去六个月内没有就诊，在前一年 GP 发现的抑郁症较少，在过去三个月的管理中也不那么积极。医学培训和继续教育应包括更好地指导如何处理这一特定人群的自杀风险。
