Rahme Elham, Low Nancy C P, Lamarre Suzanne, Turecki Gustavo, Bonin Jean-Pierre, Diane Daneau R N, Habel Youssef, Yung Emily C C, Morin Suzanne, Szkrumelak Nadia, Singh Santokh, Renaud Johanne, Lesage Alain
Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada.
Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Psychiatry, McGill University Health Centre, Montreal, Quebec, Canada; Mental Health Service, Services for Students, McGill University, Montreal, Quebec, Canada.
Prim Care Companion CNS Disord. 2015 Oct 29;17(5). doi: 10.4088/PCC.15m01806. eCollection 2015.
We conducted a chart review to identify postsecondary students and nonstudents in the same age range who presented to the emergency department following a suicide attempt to (1) compare demographic characteristics and suicide risk factors and (2) determine factors associated with more serious attempts requiring hospitalizations.
The study was conducted in 1 tertiary trauma hospital and 1 community hospital affiliated with McGill University, Montreal, Quebec, Canada, between January 1, 2009, and March 31, 2010. Charts of patients with potential suicide attempts were identified from medical records using ICD-10 codes that indicated traumatic injury, intentional self-harm, poisoning, and psychiatric or perception/cognition disorders and from the emergency department triage file using keywords that indicated suicidality or self-harm at presentation.
In multivariable logistic regression models (odds ratio, 95% CI), students were younger (per 5-year increase: 0.22, 0.12-0.41), less likely to be born in Canada (0.17, 0.06-0.44), and more likely to use less violent methods (laceration, poisoning, other, multiple methods) versus more violent methods (collision, jump, fire burns, firearm, hanging) in their attempt. Fewer students had a history of substance abuse (0.12, 0.02-0.94) but were not different from nonstudents on history of other mental disorders. Less students attempted suicide in the winter/spring (January-April) versus fall (September-December) semester (0.32, 0.11-0.91). Students who attempted suicide were more likely to have family/social support. Those who attempted suicide in the previous year were more likely to require hospitalization for their current suicide attempt.
Knowledge of specific factors associated with suicide attempts in young people can help inform and guide suicide prevention efforts in both academic and community settings. Specific to the findings of this study regarding the method of suicide attempt used, for example, limiting access to dangerous substances or large quantities of medications may help prevent or reduce suicide attempts in this population.
我们进行了一项病历回顾，以识别在自杀未遂后前往急诊科就诊的同一年龄段的高等院校学生和非学生，(1) 比较人口统计学特征和自杀风险因素，(2) 确定与需要住院治疗的更严重自杀未遂相关的因素。
该研究于2009年1月1日至2010年3月31日在加拿大魁北克省蒙特利尔市麦吉尔大学附属的1家三级创伤医院和1家社区医院进行。从医疗记录中使用表明创伤性损伤、故意自伤、中毒以及精神或感知/认知障碍的ICD - 10编码，以及从急诊科分诊文件中使用表明就诊时存在自杀倾向或自伤的关键词，来识别有潜在自杀未遂的患者病历。
在多变量逻辑回归模型（比值比，95%置信区间）中，学生年龄更小（每增加5岁：0.22，0.12 - 0.41），在加拿大出生的可能性更低（0.17，0.06 - 0.44），并且在自杀未遂时相较于使用更暴力的方法（碰撞、跳楼、火烧、火器、上吊），更有可能使用暴力程度较低的方法（割伤、中毒、其他、多种方法）。有药物滥用史的学生较少（0.12，0.02 - 0.94），但在其他精神障碍病史方面与非学生没有差异。相较于秋季（9月至12月）学期，在冬季/春季（1月至4月）学期自杀未遂的学生更少（0.32，0.11 - 0.91）。自杀未遂的学生更有可能获得家庭/社会支持。那些在前一年有过自杀未遂的人，此次自杀未遂更有可能需要住院治疗。
了解与年轻人自杀未遂相关的具体因素有助于为学术和社区环境中的自杀预防工作提供信息并加以指导。例如，就本研究关于自杀未遂所使用方法的结果而言，限制获取危险物质或大量药物可能有助于预防或减少该人群的自杀未遂行为。
