Cho Jaelim, Lee Won Joon, Moon Ki Tae, Suh Mina, Sohn Jungwoo, Ha Kyoung Hwa, Kim Changsoo, Shin Dong Chun, Jung Sang Hyuk
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Prev Med Public Health. 2013 May;46(3):147-54. doi: 10.3961/jpmph.2013.46.3.147. Epub 2013 May 31.
Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses.
Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status.
Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p=0.021) after adjustment for residence, socioeconomic status, and morbidity.
Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.
许多流行病学研究表明，多种疾病与自杀有关。调查因身体疾病导致的自杀死亡前医疗服务利用的随时间变化模式，将有助于为身体疾病患者制定自杀预防计划。
通过国家警察机构调查员的记录确定因身体疾病导致的自杀，这些记录与健康保险审查和评估数据相关联。我们在对年龄、性别、居住地区和社会经济地位进行调整后，使用重复测量数据分析方法，调查了自杀前1年内医疗服务利用的随时间变化模式。
在1994例因身体疾病导致的自杀中，1893例（94.9%）自杀者在自杀前1年内曾接触过任何医疗服务，445例（22.3%）自杀者曾接触过心理健康护理。随着自杀日期临近，医疗就诊次数和个人医疗支出增加（p<0.001）。在对居住、社会经济地位和发病率进行调整后，仅40至64岁男性（p=0.002）、40岁以下女性（p=0.011）和40至64岁女性（p=0.021）自杀前精神疾病的医疗就诊次数显著增加。
大多数因身体疾病导致的自杀者在自杀前1年内曾接触过医疗服务，但其中许多人未接受精神科评估。这突出了为身体疾病患者提供心理社会支持项目的必要性。
