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自杀风险水平、自杀未遂特征与自杀未遂者精神障碍之间的关联。

Association between level of suicide risk, characteristics of suicide attempts, and mental disorders among suicide attempters.

机构信息

Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127 Yongma-ro, Gwangjin-gu, Seoul, South Korea.

Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, South Korea.

出版信息

BMC Public Health. 2018 Apr 11;18(1):477. doi: 10.1186/s12889-018-5387-8.

Abstract

BACKGROUND

Past attempted suicide is a strong predictor of future suicide risk, but the risk varies among suicide attempters. Hence, it is important to clarify distinguishing features of lifetime attempters with a high level of current suicide risk for efficient preventive management.

METHODS

We compared characteristics of suicide attempts and clinical characteristics among high-, moderate-, and low-risk attempters. Among the total of 6022 participants in the Korean Epidemiologic Catchment Area study, 193 reported a suicide attempt in their lifetime, 36 of which had high, 126 moderate, and 30 low levels of current suicide risk (1 incomplete response).

RESULTS

High-risk suicide attempters had more past attempts compared with moderate- and low-risk suicide attempters. Suicide attempts were closely linked to a wide range of psychiatric comorbidities regardless of degree of current level of suicide risk, but the relative risk for having at least one mental disorder was the highest in high-risk attempters. Specifically, the relative risks for depressive disorder, anxiety disorders including obsessive-compulsive disorder and post-traumatic stress disorder, and substance use disorders were higher in high-risk attempters, and relative risk for somatoform disorder was higher in low-risk attempters than others.

CONCLUSIONS

Our findings indicated that special attention is required for suicide attempters with a history of repeated attempts and current mental disorders, particularly anxiety disorders.

摘要

背景

既往自杀未遂是未来自杀风险的强烈预测因素,但自杀未遂者的风险存在差异。因此,明确具有高当前自杀风险的终身未遂者的区别特征对于有效的预防管理非常重要。

方法

我们比较了高、中、低风险未遂者的自杀尝试特征和临床特征。在韩国流行病学抽样调查研究的总共 6022 名参与者中,有 193 人报告了一生中的自杀未遂,其中 36 人有高、126 人有中、30 人有低当前自杀风险(1 个不完整回复)。

结果

与中、低风险自杀未遂者相比,高风险自杀未遂者过去的自杀尝试次数更多。自杀未遂与广泛的精神共病密切相关,无论当前自杀风险程度如何,但在高风险未遂者中,至少有一种精神障碍的相对风险最高。具体而言,高风险未遂者中抑郁障碍、包括强迫症和创伤后应激障碍在内的焦虑障碍以及物质使用障碍的相对风险较高,而躯体形式障碍在低风险未遂者中的相对风险高于其他障碍。

结论

我们的研究结果表明,对于有反复自杀史和当前精神障碍的自杀未遂者,特别是焦虑障碍,需要特别关注。

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