Chang Shu-Sen, Steeg Sarah, Kapur Navneet, Webb Roger T, Yip Paul S F, Cooper Jayne
Institute of Health Policy and Management, and Department of Public Health, College of Public Health, National Taiwan University, No 17, Xuzhou Road, Taipei, 10055, Taiwan.
The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong, SAR, China.
BMC Psychiatry. 2015 Apr 14;15:79. doi: 10.1186/s12888-015-0467-0.
There has been little previous research on self-harm among people of Chinese origin living in the UK, although this population has grown substantially in recent years and China is now the largest source of international students at UK universities.
We conducted a prospective cohort study using self-harm presentation data (1997-2011) collected from three hospitals in the City of Manchester, which has the largest Chinese population across all UK Local Authorities. Rate ratios between the Chinese and White groups were calculated using Poisson regression models. Chi-square tests (or Fisher's exact tests), logistic regression, and log-binomial regression were used to examine differences in characteristics and clinical management between groups.
Ethnicity was known in the study cohort for 23,297 (87%) amongst 26,894 individuals aged 15 years and above. A total number of 97/23,297 (0.4%) people of Chinese ethnic origin presented with self-harm over the study period and 20,419 (88%) were White people. Incidence of self-harm in the Chinese group (aged 16-64 years) was less than one fifth of that found in White people (0.6 versus 3.2 per 1000 person-years; rate ratio 0.18, 95% confidence interval 0.13-0.24), and was particularly low amongst men of Chinese origin. Individuals of Chinese origin who presented with self-harm were younger, more likely to be female and students, and more likely to self-injure and describe relationship problems as a precipitant than White people. They were less likely to have clinical risk factors such as drug/alcohol misuse and receiving psychiatric treatment, and were rated to have lower risk of self-harm repetition by treating clinicians.
Future research needs to investigate whether the low incidence of self-harm presenting to hospitals amongst people of Chinese origin truly reflects a lower frequency of self-harm, or alternatively is due to markedly different post-episode help-seeking behaviours or student overrepresentation in this ethnic group. Relevant healthcare professionals need to be aware of the risk characteristics of people of Chinese origin who self-harm.
尽管近年来居住在英国的华裔人口大幅增长，且中国目前是英国大学国际学生的最大来源国，但此前针对这一群体的自我伤害研究较少。
我们进行了一项前瞻性队列研究，使用从曼彻斯特市三家医院收集的自我伤害就诊数据（1997 - 2011年），曼彻斯特市是英国所有地方当局中华裔人口最多的地区。使用泊松回归模型计算华裔和白人组之间的率比。卡方检验（或费舍尔精确检验）、逻辑回归和对数二项回归用于检验两组之间特征和临床管理的差异。
在26,894名15岁及以上的个体中，研究队列中有23,297人（87%）的种族信息已知。在研究期间，共有97/23,297（0.4%）的华裔出现自我伤害，20,419人（88%）为白人。华裔群体（16 - 64岁）的自我伤害发生率不到白人的五分之一（每1000人年0.6例对3.2例；率比0.18，95%置信区间0.13 - 0.24），在华裔男性中尤其低。出现自我伤害的华裔个体更年轻，更可能为女性和学生，与白人相比，更可能自我伤害并将人际关系问题描述为诱因。他们不太可能有药物/酒精滥用和接受精神治疗等临床风险因素，治疗临床医生评定他们自我伤害重复的风险较低。
未来的研究需要调查华裔人群中到医院就诊的自我伤害低发生率是真的反映了自我伤害频率较低，还是由于发作后寻求帮助行为明显不同，或者是该种族群体中学生比例过高。相关医疗保健专业人员需要了解自我伤害的华裔人群的风险特征。
