精神分裂症患者的自杀：多伦多验尸官记录的观察性研究。

Suicide in schizophrenia: an observational study of coroner records in Toronto.

机构信息

2075 Bayview Ave, FG52, Toronto, Ontario, M4N 3M5, Canada

出版信息

J Clin Psychiatry. 2015 Jan;76(1):e98-103. doi: 10.4088/JCP.14m09047.

DOI:10.4088/JCP.14m09047

PMID:25650686

Abstract

OBJECTIVE

Suicide is an important cause of premature mortality in people suffering from schizophrenia. This study aimed to identify demographic, personal, and suicide-specific features that distinguish suicide in people with schizophrenia from those with another severe mental illness (bipolar disorder) and those with neither illness.

METHOD

We conducted a coroner's chart review for 2,886 suicide victims in Toronto from 1998 to 2010. Diagnoses were made based on coroner interviews with available informants including family members, acquaintances, the deceased's physician(s) and/or review of medical records. Of the total, 258 formed what we defined as the schizophrenia group (204 schizophrenia, 34 unspecified psychotic illness, and 20 schizoaffective disorder). Of the remainder, 169 had bipolar disorder, and 2,459 had neither illness. One-way analysis of variance (ANOVA) tests and χ² tests were conducted to examine differences between the groups.

RESULTS

The group with schizophrenia was the youngest (mean age for schizophrenia, 41.0 years; bipolar disorder, 43.3 years; and neither, 47.7 years; P < .001), most likely to have never been married (schizophrenia, 75.6%; bipolar disorder, 57.4%; and neither, 52.9%; P < .001), most likely to be living in temporary/assisted housing or jail (schizophrenia, 9.3%; bipolar disorder, 5.4%; and neither, 3.2%; P < .001), and least likely to have experienced a recent stressor (schizophrenia, 26.7%; bipolar disorder, 37.9%; and neither, 54.1%; P < .001). The schizophrenia group was the most likely to use a violent cause of death, specifically by fall from a height or by jumping in front of a vehicle (schizophrenia, 81.4%; bipolar disorder, 58.0%; and neither, 73.1%; P < .001).

CONCLUSIONS

There are important demographic and suicide-related differences between suicide victims with and without schizophrenia. Notably, suicide in schizophrenia overall appears to be more illness driven and occurs by more violent means than in the bipolar disorder group or those with neither illness.

摘要

目的

自杀是精神分裂症患者过早死亡的一个重要原因。本研究旨在确定人口统计学、个人和自杀特定特征，以区分精神分裂症患者、双相情感障碍患者和无精神疾病患者的自杀。

方法

我们对 1998 年至 2010 年在多伦多自杀的 2886 名验尸官记录进行了回顾。根据与可用信息提供者（包括家属、熟人、死者的医生和/或病历回顾）的验尸官访谈做出诊断。在这些人中，有 258 人属于我们定义的精神分裂症组（204 例精神分裂症、34 例未特指的精神病性疾病和 20 例分裂情感障碍）。其余 169 例为双相情感障碍患者，2459 例无精神疾病。采用单因素方差分析（ANOVA）检验和卡方检验比较各组间差异。

结果

精神分裂症组的年龄最小（精神分裂症组平均年龄为 41.0 岁，双相情感障碍组为 43.3 岁，无精神疾病组为 47.7 岁；P<0.001），从未结婚的可能性最大（精神分裂症组为 75.6%，双相情感障碍组为 57.4%，无精神疾病组为 52.9%；P<0.001），最有可能居住在临时/援助性住房或监狱中（精神分裂症组为 9.3%，双相情感障碍组为 5.4%，无精神疾病组为 3.2%；P<0.001），且最近经历应激源的可能性最小（精神分裂症组为 26.7%，双相情感障碍组为 37.9%，无精神疾病组为 54.1%；P<0.001）。精神分裂症组最有可能使用暴力作为死因，特别是从高处坠落或被车辆撞击（精神分裂症组为 81.4%，双相情感障碍组为 58.0%，无精神疾病组为 73.1%；P<0.001）。