Simsek Zeynep, Demir Canan, Er Gülistan, Munir Kerim M
Z Gesundh Wiss. 2013 Aug;21(4):325-331. doi: 10.1007/s10389-013-0558-7.
Attempted suicide is one of the most important public health problems among preventable causes of mortality in the general population. Identifying risk factors for the prevention of suicide is a major public health goal. The aim of this study was to determine the annual rate of attempted suicide, related risk factors, and interventions, among referrals to emergency departments in the Sanliurfa province of southeastern Turkey.
Data were obtained from all emergency departments in the province based on the 'Suicide Attempt Registry' standardized records for the calendar year 2010. Sociodemographic characteristics, aetiology, psychiatric history, psychiatric consultations, and interventions were examined. The groups were analysed with the chi-square test; the significance level was set at <0.05.
The annual rate of suicide attempts was 55.39 in 100,000 for the calendar year 2010. The rate was 3.47 times higher among women than men, and in particular 4.15 times higher for the 15-24 year age group among women than in men with the highest incidence of suicide attempts. The majority of cases were referred in April and May. Medication or toxic agent ingestions comprised 90.3 % of cases. The main reason for attempts was family problems or domestic violence among women, and economic hardships among men, and rates of physical and mental problems were similar for both sexes. Only 8.8 % of cases were subsequently referred for psychiatric consultation. Among cases with a prior suicide attempt history, 44.6 % had a reported psychiatric disorder.
The results of this investigation show that strengthening of surveillance and emergency healthcare systems, enhancement of mental health literacy, and inter-sector collaboration for development of community empowerment programmes are of vital importance for prevention of attempted suicide. The low rate of psychiatric referrals for subsequent intervention represented a major gap in urgent mental health services in the region.
在普通人群可预防的死亡原因中,自杀未遂是最重要的公共卫生问题之一。识别自杀预防的风险因素是一项主要的公共卫生目标。本研究的目的是确定土耳其东南部桑尼乌法省急诊科转诊患者中的年度自杀未遂率、相关风险因素及干预措施。
基于2010日历年的“自杀未遂登记处”标准化记录,从该省所有急诊科获取数据。对社会人口学特征、病因、精神病史、精神科会诊及干预措施进行了检查。采用卡方检验对各组进行分析;显著性水平设定为<0.05。
2010日历年的年度自杀未遂率为每10万人中有55.39例。女性的自杀未遂率是男性的3.47倍,尤其是15 - 24岁年龄组的女性自杀未遂率是男性的4.15倍,该年龄组女性自杀未遂发生率最高。大多数病例在4月和5月被转诊。药物或有毒物质摄入占病例的90.3%。女性自杀未遂的主要原因是家庭问题或家庭暴力,男性则是经济困难,两性的身心问题发生率相似。随后只有8.8%的病例被转诊进行精神科会诊。在有自杀未遂史的病例中,44.6%报告有精神障碍。
本调查结果表明,加强监测和紧急医疗保健系统、提高心理健康素养以及跨部门合作制定社区赋权计划对于预防自杀未遂至关重要。后续干预的精神科转诊率较低,这是该地区紧急心理健康服务的一个主要缺口。