Narishige Ryuichiro, Kawashima Yoshitaka, Otaka Yasushi, Saito Takuya, Okubo Yoshiro
Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
BMC Psychiatry. 2014 May 19;14:144. doi: 10.1186/1471-244X-14-144.
There is a shortage of empirical data concerning precipitating factors for suicides in Japan. The purpose of the present study was to clarify gender differences of precipitating factors for suicide attempts in Japan.
The subjects were high-lethality suicide attempters who were admitted to the Nippon Medical School Hospital Critical Care Medical Center between March 1, 2010 and March 31, 2012. Precipitating factors for suicide attempt, method of suicide attempt, psychiatric diagnoses and other sociodemographic data were collected from the patients' medical records retrospectively, and statistical analyses were performed for categorical variables of male/female.
The total number of subjects was 193 (88 males and 105 females). The rate of subjects attempting suicide by poisonous gas was significantly higher in males while that of subjects attempting suicide by drug overdose was significantly higher in females. The rate of subjects diagnosed with "major depressive disorder, bipolar disorder" was significantly higher in males while that of subjects diagnosed with "personality disorders" or "dysthymic disorder" was significantly higher in females. Subjects with "health problems", "financial problems", "work problems", "debts (others)" or "unwanted transfer" were significantly more numerous among males; subjects with "family problems", "parent-child relations" or "loneliness" were significantly more frequently found among females.
Mental disorders were the most common precipitating factor for suicide attempts regardless of gender. Significant gender differences were observed in psychiatric diagnoses, methods of suicide attempt and psychosocial problems. This indicates the necessity of suicide prevention measures corresponding to these gender differences.
关于日本自杀诱发因素的实证数据匮乏。本研究的目的是阐明日本自杀未遂诱发因素的性别差异。
研究对象为2010年3月1日至2012年3月31日期间入住日本医科大学医院重症医学中心的高致死性自杀未遂者。从患者病历中回顾性收集自杀未遂的诱发因素、自杀未遂方法、精神科诊断及其他社会人口学数据,并对男性/女性的分类变量进行统计分析。
研究对象总数为193人(男性88人,女性105人)。男性使用毒气自杀未遂的比例显著高于女性,而女性药物过量自杀未遂的比例显著高于男性。被诊断为“重度抑郁症、双相情感障碍”的男性比例显著高于女性,而被诊断为“人格障碍”或“恶劣心境障碍”的女性比例显著高于男性。男性中存在“健康问题”“经济问题”“工作问题”“债务(其他)”或“非自愿调动”的人数显著更多;女性中存在“家庭问题”“亲子关系”或“孤独感”的情况显著更常见。
无论性别,精神障碍都是自杀未遂最常见的诱发因素。在精神科诊断、自杀未遂方法和心理社会问题方面观察到显著的性别差异。这表明有必要采取针对这些性别差异的自杀预防措施。