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癌症患者群体中的自杀率更高吗?一项基于法医尸检数据的调查。

Are suicide rates higher in the cancer population? An investigation using forensic autopsy data.

作者信息

de la Grandmaison Geoffroy Lorin, Watier Laurence, Cavard Stéphanie, Charlier Philippe

机构信息

Department of Forensic Medicine and Pathology, Raymond Poincaré Hospital, AP-HP, Versailles Saint-Quentin University, 104 Boulevard Raymond Poincaré, 92380 Garches, France.

Department of Public Health (INSERM U657), Versailles Saint-Quentin University (EA4499), 104 Boulevard Raymond Poincaré, 92380 Garches, France.

出版信息

Med Hypotheses. 2014 Jan;82(1):16-9. doi: 10.1016/j.mehy.2013.10.025. Epub 2013 Nov 9.

Abstract

Previous population-based studies have identified increased suicide rates among cancer patients. Available post mortem data on the contribution of cancer to completed suicide are limited, however. This study examines forensic autopsy data in order to assess whether cancer is significantly more frequent in a suicide population compared with a control population. In total, 232 cases were included in both the suicide and the control groups. Based on a complete standard histological examination, cancer was significantly more often found in the suicide group than in the control one (8.6% vs. 3.9%, p=0.03). The multivariate analysis also showed that the presence of cancer increased the risk of suicide. Moreover, cancer was not known to the deceased in 70% of cases, while the most frequent mental disease found in cancer-related suicide cases was depression (75%). In the 20 cancer-related suicide cases analysed herein, it was difficult to ascertain whether malignancy was the only motive for committing suicide, as cancer could be considered to be either a major causative factor for suicide or an incidental finding. Therefore, further research is warranted with the help of the psychological autopsy method to investigate the link between suicide and cancer further.

摘要

以往基于人群的研究发现癌症患者的自杀率有所上升。然而,关于癌症对自杀死亡影响的现有尸检数据有限。本研究通过法医尸检数据来评估自杀人群中癌症的发生率是否显著高于对照人群。自杀组和对照组共纳入232例病例。基于完整的标准组织学检查,自杀组中癌症的发现率显著高于对照组(8.6%对3.9%,p=0.03)。多因素分析还显示,癌症的存在增加了自杀风险。此外,70%的病例中死者生前不知患有癌症,而在与癌症相关的自杀病例中最常见的精神疾病是抑郁症(75%)。在本文分析的20例与癌症相关的自杀病例中,很难确定恶性肿瘤是否是自杀的唯一动机,因为癌症既可以被视为自杀的主要病因,也可以被视为偶然发现。因此,有必要借助心理解剖方法进行进一步研究,以深入探讨自杀与癌症之间的联系。

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