Sinyor Mark, Kozloff Nicole, Reis Catherine, Schaffer Ayal
1 Mood and Anxiety Disorders Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario.
2 Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario.
Can J Psychiatry. 2017 Jul;62(7):501-505. doi: 10.1177/0706743717705354. Epub 2017 May 19.
Homelessness has been identified as an important risk factor for suicide death, but there is limited research characterising homeless people who die by suicide. The goal of this study is to identify personal, clinical, and suicide method-related factors that distinguish homeless and precariously housed people who die from suicide from those who are not homeless at the time of suicide.
Coroner records were reviewed for all suicide deaths in Toronto from 1998 to 2012. Data abstracted included housing status as well as other demographics, clinical variables such as the presence of mental illness, and suicide method.
Of 3319 suicide deaths, 60 (1.8%) were homeless and 230 (6.9%) were precariously housed. Homeless and precariously housed people were each younger than nonhomeless people ( P < 0.0001). Compared with nonhomeless, homeless people were more likely to be male and less likely to be married, to have interpersonal conflict, or to leave a suicide note. Homeless people and precariously housed were more likely to have died by fall/jump than nonhomeless people (62%, 57%, and 29%, respectively).
Homeless and precariously housed people are overrepresented among suicide deaths in a large urban center and differ demographically, clinically, and in their suicide method from nonhomeless people who die by suicide. Targeted suicide prevention strategies should aim to address factors specific to homeless people.
无家可归已被确定为自杀死亡的一个重要风险因素，但对死于自杀的无家可归者进行特征描述的研究有限。本研究的目的是确定个人、临床和与自杀方法相关的因素，以区分死于自杀的无家可归者和居住状况不稳定者与自杀时并非无家可归的人。
回顾了1998年至2012年多伦多所有自杀死亡的验尸官记录。提取的数据包括住房状况以及其他人口统计学信息、临床变量（如精神疾病的存在情况）和自杀方法。
在3319例自杀死亡案例中，60例（1.8%）为无家可归者，230例（6.9%）居住状况不稳定。无家可归者和居住状况不稳定者均比非无家可归者年轻（P<0.0001）。与非无家可归者相比，无家可归者更可能为男性，结婚的可能性较小，发生人际冲突的可能性较小，留下自杀遗书的可能性较小。无家可归者和居住状况不稳定者因坠落/跳楼死亡的可能性比非无家可归者更高（分别为62%、57%和29%）。
在一个大型城市中心，无家可归者和居住状况不稳定者在自杀死亡者中所占比例过高，在人口统计学、临床特征和自杀方法方面与死于自杀的非无家可归者不同。有针对性的自杀预防策略应旨在解决无家可归者特有的因素。
