Shah Ravi, Eynan Rahel, Heisel Marnin J, Eden David, Jhirad Reuven, Links Paul S
Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, Parkwood Institute Research, Mental Health Care Bldg, 550 Wellington Rd, Room F5-361, London, Ontario N6C 0A7.
Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Prim Care Companion CNS Disord. 2018 Mar 8;20(2):17m02217. doi: 10.4088/PCC.17m02217.
To describe sociodemographic and clinical characteristics of suicide decedents and to explore the pattern of clinical and suicide risk assessment in primary care settings.
A 3-year case series of consecutive suicides (January 1, 2012, to December 31, 2014) in Southwestern Ontario, Canada, identified by the Office of the Chief Coroner of Ontario and Ontario Forensic Pathology Service (OCC/OFPS) was conducted. Clinicians who provided care to suicide decedents completed a confidential suicide questionnaire offered online through a secured portal or by hardcopy.
A total of 476 suicide cases were analyzed using data extracted from the OCC/OFPS files or provided by clinicians who had completed the survey. Hanging (42.8%) was the most common method of suicide, followed by self-poisoning (17.9%). More than half of the decedents (51.8%) used psychotropic medications, and 29.4% used opiates to self-poison. Typically, these self-poisonings involved prescribed medications (70.6%). Over two-thirds (67.4%) of suicide decedents had consulted their primary care physician prior to their deaths, and 63.6% had been seen by a physician within 28 days of their death. Suicide risk assessments were reportedly conducted in 87.1% of these visits. Of those who were assessed, the immediate risk of suicide was deemed to be absent in 39.8%, low in 50.0%, moderate in 8.3%, and high in only 1.9%.
The findings from this confidential survey may be important for the formulation of recommendations that could improve suicide prevention in primary care practice.
描述自杀死亡者的社会人口学和临床特征，并探讨初级保健机构中的临床及自杀风险评估模式。
对安大略省西南部（2012年1月1日至2014年12月31日）连续3年的自杀案例进行了系列研究，这些案例由安大略省首席验尸官办公室和安大略法医病理服务局（OCC/OFPS）识别。为自杀死亡者提供护理的临床医生通过安全门户网站在线或通过纸质版完成了一份保密的自杀调查问卷。
共分析了476例自杀案例，数据来自OCC/OFPS文件或完成调查的临床医生提供的信息。上吊（42.8%）是最常见的自杀方式，其次是自我中毒（17.9%）。超过一半的死亡者（51.8%）使用精神药物，29.4%使用阿片类药物进行自我中毒。通常，这些自我中毒涉及处方药（70.6%）。超过三分之二（67.4%）的自杀死亡者在死亡前咨询过他们的初级保健医生，63.6%在死亡前28天内看过医生。据报道，在这些就诊中，87.1%进行了自杀风险评估。在接受评估的人中，39.8%被认为不存在立即自杀风险，50.0%为低风险，8.3%为中度风险，只有1.9%为高风险。
这项保密调查的结果对于制定可改善初级保健实践中自杀预防的建议可能具有重要意义。
