Kyung Hee University School of Medicine, Seoul, South Korea.
Health Insurance Review and Assessment Service, Wonju, South Korea.
J Am Acad Child Adolesc Psychiatry. 2018 Jul;57(7):508-514.e1. doi: 10.1016/j.jaac.2018.04.011. Epub 2018 May 25.
The postdischarge suicide rate in children and adolescents ever hospitalized for a psychiatric illness is much higher than that of children and adolescents in the general population. We aimed to investigate the postdischarge death and suicide among children and adolescents hospitalized for a psychiatric illness using the Korean National Health Insurance database and causes of death statistics from the National Statistics Office.
We identified children and adolescents less than 18 years of age who experienced at least one psychiatric hospitalization from 2008 to 2013 with a principal diagnosis of a psychiatric disorder based on the International Classification of Diseases, 10th Revision, Code Fxx.x). Postdischarge deaths (all-cause death or suicide) after the first psychiatric hospitalization were investigated.
The total number of patients hospitalized for a psychiatric illness was 14,097, and the numbers of all-cause deaths and suicide deaths after discharge were 93 and 64, respectively. The rates of suicide according by diagnostic group were 440.1 (per 100,000 person-years) for psychosis, 248.8 for depression, 155.4 for conduct disorder, 153.6 for bipolar disorder, 103.4 for posttraumatic stress disorder, 93.0 for anxiety disorder, and 38.4 for attention-deficit/hyperactivity disorder.
As suicide is the main cause of postdischarge death, there is an urgent need to develop and implement effective prevention strategies after psychiatric hospitalization.
曾因精神疾病住院的儿童和青少年的出院后自杀率远高于一般人群中的儿童和青少年。我们旨在使用韩国国家健康保险数据库和国家统计局的死亡原因统计数据,调查因精神疾病住院的儿童和青少年的出院后死亡和自杀情况。
我们根据国际疾病分类第 10 版(ICD-10)Fxx.x 代码,确定了 2008 年至 2013 年期间至少有一次精神科住院治疗且主要诊断为精神障碍的 18 岁以下儿童和青少年。调查了首次精神科住院后出院后的死亡(全因死亡或自杀)情况。
共住院治疗精神疾病的患者为 14097 人,出院后全因死亡和自杀死亡的人数分别为 93 人和 64 人。按诊断组划分的自杀率分别为精神病 440.1(每 10 万人年)、抑郁症 248.8、品行障碍 155.4、双相情感障碍 153.6、创伤后应激障碍 103.4、焦虑障碍 93.0 和注意缺陷多动障碍 38.4。
由于自杀是出院后死亡的主要原因,因此迫切需要在精神科住院后制定和实施有效的预防策略。