Section of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, 1-5-11 Nishi-Shinbashi, Minato-ku, Tokyo 105-0003, Japan.
Asian J Psychiatr. 2018 Mar;33:121-125. doi: 10.1016/j.ajp.2017.11.005. Epub 2017 Nov 7.
Suicidal behavior accounts for at least 40,000 admissions per year to emergency departments in Japan; however, little is known about emergency admissions owing to suicidal behavior in metropolitan areas. Therefore, we examined the clinical characteristics of suicidal behavior using psychosocial assessments performed by experienced psychiatrists in an intensive care unit.
Participants were 971 patients admitted to a university hospital's intensive care unit for suicidal behavior between July 2006 and June 2013. Physicians and psychiatrists regularly assessed the participants using a standard data extraction form while the participants were in the intensive care unit. As suicidal behavior involving drug overdose is generally less fatal than other methods, we predicted that clinical characteristics would differ between patients with and without overdose. We classified participants into drug overdose or other method groups (ns=732 and 239, respectively) to compare suicide methods.
In the overdose group, participants' median age was approximately 5 years lower, and the following proportions were larger: female participants (77%) and participants with borderline personality disorders (21% vs. 10%), no clear suicidal ideation (30% vs. 15%), impulsively attempted self-harm (86% vs. 62%), and interpersonal problems (26% vs. 16%).
Ameliorating interpersonal problems and improving stress coping skills would benefit people who attempt suicide via overdose.
日本每年至少有 4 万人因自杀行为被送往急诊科就诊；然而，对于大都市地区因自杀行为而导致的急诊入院情况知之甚少。因此，我们使用经验丰富的精神科医生在重症监护病房进行的心理社会评估，来研究自杀行为的临床特征。
研究对象为 2006 年 7 月至 2013 年 6 月期间因自杀行为被收入大学医院重症监护病房的 971 名患者。在重症监护病房期间，医生和精神科医生定期使用标准数据提取表对参与者进行评估。由于药物过量引起的自杀行为通常比其他方法的致死性低，我们预测患者的临床特征在药物过量和非药物过量组之间会有所不同。我们将参与者分为药物过量或其他方法组（分别为 732 例和 239 例），以比较自杀方法。
在药物过量组中，参与者的中位年龄低约 5 岁，以下比例更大：女性参与者（77%）和患有边缘型人格障碍的参与者（21%比 10%）、没有明确自杀意念的参与者（30%比 15%）、冲动性自伤的参与者（86%比 62%）和人际关系问题的参与者（26%比 16%）。
改善人际关系问题和提高应对压力的技能将有益于通过药物过量自杀的人。
