Kawashima Yoshitaka, Yonemoto Naohiro, Inagaki Masatoshi, Yamada Mitsuhiko
Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashimachi, Kodaira, Tokyo 187-8553, Japan.
Department of Epidemiology and Biostatistics, Translational Medical Center, National Centre of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
J Affect Disord. 2014 Jul;163:33-9. doi: 10.1016/j.jad.2014.03.025. Epub 2014 Apr 4.
The number of hospital admissions related to suicide attempts is increasing worldwide. The Emergency Department (ED) is recognized in Japan as an opportunity to intervene with suicide attempters however, the prevalence of suicide attempters in the ED is unknown. Therefore, a meta-analysis was conducted to provide this information.
We conducted searches of databases (PubMed, PsycINFO, CINAHL, ICHUSHI, CiNii) to identify studies about suicide attempters in the ED in Japan. A meta-analysis was used to calculate the pooled prevalence proportion of suicide attempters in the ED, and their prevalence proportion of psychiatric disorder and method of suicide in suicide attempters.
The search of Japanese studies identified 3338 records, of which 70 were included in the meta-analysis. A total of 25 studies reported the psychiatric diagnosis and 62 studies reported the method of suicide. The pooled prevalence proportion of suicide attempters was 4.7%. Mood disorders were the most frequent psychiatric disorders (ICD: 30%, DSM: 35%), and poisoning was the most frequent method of attempting suicide (52%).
There might be a publication bias because only published studies were included. There also might be an information bias, such as reporting bias or misclassification, because most of studies included in the analysis used retrospective designs.
The results provide clear evidence of the prevalence of suicide attempters in the ED in Japan. The results indicate that suicide attempters in the ED have a higher proportion of mood disorders, and that the most common method of suicide is poisoning.
全球范围内,因自杀未遂而住院的人数正在增加。在日本,急诊科被视为干预自杀未遂者的一个契机,然而,急诊科自杀未遂者的患病率尚不清楚。因此,我们进行了一项荟萃分析以获取这一信息。
我们检索了多个数据库(PubMed、PsycINFO、CINAHL、ICHUSHI、CiNii),以查找有关日本急诊科自杀未遂者的研究。采用荟萃分析来计算急诊科自杀未遂者的合并患病率,以及他们的精神障碍患病率和自杀未遂者的自杀方式。
对日本研究的检索共识别出3338条记录,其中70条纳入了荟萃分析。共有25项研究报告了精神科诊断情况,62项研究报告了自杀方式。自杀未遂者的合并患病率为4.7%。情绪障碍是最常见的精神障碍(国际疾病分类:30%,精神疾病诊断与统计手册:35%),中毒是最常见的自杀方式(52%)。
由于仅纳入了已发表的研究,可能存在发表偏倚。由于分析中纳入的大多数研究采用回顾性设计,也可能存在信息偏倚,如报告偏倚或错误分类。
研究结果为日本急诊科自杀未遂者的患病率提供了明确证据。结果表明,急诊科自杀未遂者中情绪障碍的比例较高,最常见的自杀方式是中毒。