Chen Chien-Hua, Lin Cheng-Li, Hsu Chung-Y, Kao Chia-Hung
Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan.
Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang, Taiwan.
Front Psychiatry. 2018 Apr 18;9:147. doi: 10.3389/fpsyt.2018.00147. eCollection 2018.
The actual incidence rate of suicide attempt and the suicide-related fatality rate (completed suicide) in patients with chronic pancreatitis (CP) have not been mentioned in the literature. We conducted a nationwide population-based cohort study by analyzing data from Taiwan's National Health Insurance Research Database (NHIRD) to compare the rate of suicide attempt between a CP cohort and a non-CP cohort. For the study cohort, we identified 17,733 patients (age ≥ 20 years) diagnosed as having CP between 2000 and 2010 from the NHIRD in Taiwan. Beneficiaries with no history of CP were matched with the study cohort at a 2:1 ratio according to age, sex, and index date. To determine the incidence of suicide, all patients were followed until the end of 2011 or until their withdrawal from the Taiwan National Health Insurance program. Patients with CP had an increased risk of suicide attempt, compared with those without CP (adjusted hazard ratio [aHR] = 2.72, 95% confidence interval [CI] = 1.69-4.37). The suicide-related fatality in the CP cohort was higher than that in the non-CP cohort, but the difference was not statistically significant (aHR = 1.21, 95% CI = 0.39-3.78). Our population-based cohort study reveals a close association between CP and subsequent suicide attempt. Compared with the non-CP cohort, the suicide-related fatality was higher in the CP cohort, although the result was not statistically significant. These findings necessitate surveying patients with CP and providing psychological support to prevent suicide.
慢性胰腺炎（CP）患者自杀未遂的实际发生率以及与自杀相关的死亡率（自杀身亡）在文献中尚未提及。我们通过分析台湾国民健康保险研究数据库（NHIRD）的数据进行了一项基于全国人群的队列研究，以比较CP队列和非CP队列之间的自杀未遂率。对于研究队列，我们从台湾的NHIRD中确定了2000年至2010年间被诊断患有CP的17733名患者（年龄≥20岁）。没有CP病史的受益人根据年龄、性别和索引日期以2:1的比例与研究队列进行匹配。为了确定自杀发生率，所有患者均随访至2011年底或直至他们退出台湾国民健康保险计划。与没有CP的患者相比，CP患者自杀未遂的风险增加（调整后风险比[aHR]=2.72，95%置信区间[CI]=1.69-4.37）。CP队列中与自杀相关的死亡人数高于非CP队列，但差异无统计学意义（aHR=1.21，95%CI=0.39-3.78）。我们基于人群的队列研究揭示了CP与随后自杀未遂之间的密切关联。与非CP队列相比，CP队列中与自杀相关的死亡人数更高，尽管结果无统计学意义。这些发现需要对CP患者进行调查并提供心理支持以预防自杀。
