Department of Biomedicine, Aarhus University, Aarhus - 8000, Denmark.
Int J Law Psychiatry. 2013 Sep-Dec;36(5-6):339-42. doi: 10.1016/j.ijlp.2013.06.004. Epub 2013 Jul 17.
The relative contributions of psychiatric morbidity and psychosocial stress to suicide, and the efficacy of mental health systems in reducing population suicide rates, are currently unclear. This study, therefore, aimed to investigate whether national suicide rates are associated with their corresponding mental health system indicators.
Relevant data were retrieved from the following sources: the World Health Organization, the United Nations Statistics Division and the Central Intelligence Agency World Fact book. Suicide rates of 191 countries were compared with their mental health system indicators using an ecological study design and multivariate non-parametric robust regression models.
Significant positive correlations between suicide rates and mental health system indicators (p<0.001) were documented. After adjusting for the effects of major macroeconomic indices using multivariate analyses, numbers of psychiatrists (p=0.006) and mental health beds (p<0.001) were significantly positively associated with population suicide rates.
Countries with better psychiatric services experience higher suicide rates. Although these associations should be interpreted with caution, as the issues are complex, we suggest that population-based public health strategies may have greater impact on national suicide rates than curative mental health services for individuals.
目前尚不清楚精神疾病发病率和心理社会压力对自杀的相对贡献，以及心理健康系统降低人群自杀率的效果。因此，本研究旨在调查国家自杀率是否与其相应的心理健康系统指标相关。
从以下来源检索相关数据：世界卫生组织、联合国统计司和中央情报局世界概况。采用生态研究设计和多元非参数稳健回归模型，将 191 个国家的自杀率与其心理健康系统指标进行比较。
记录到自杀率与心理健康系统指标之间存在显著正相关（p<0.001）。经多元分析调整主要宏观经济指标的影响后，精神科医生人数（p=0.006）和精神科床位（p<0.001）与人群自杀率呈显著正相关。
精神卫生服务较好的国家自杀率较高。尽管这些关联应该谨慎解释，因为问题很复杂，但我们建议，基于人群的公共卫生策略对国家自杀率的影响可能大于针对个人的治疗性心理健康服务。
