Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
School of Medicine, Tzu-Chi University, Hualien, Taiwan.
Suicide Life Threat Behav. 2019 Aug;49(4):966-979. doi: 10.1111/sltb.12497. Epub 2018 Aug 6.
The aim of this study was to analyze the risk of inpatient suicide in patients with schizophrenia during 2007-2013 and to determine putative risk factors.
We conducted a national population-based cohort study of 2,038 psychiatric inpatients in their first compulsory admission, matched with 8,152 controls who were voluntary inpatients. Only patients with schizophrenia were included in the study. We used data derived from the Taiwanese National Health Insurance Database 2005, comprising 1 million beneficiaries randomly selected from the entire population of Taiwan.
During the follow-up period, 23 and 75 inpatient suicides were observed in the compulsory and control groups, respectively. Kaplan-Meier curves showed that the cumulative incidence rate of inpatient suicide was not significantly different between compulsory and voluntary admissions (log-rank test, p = .206).
Our results suggest that compulsory admission has no protective effects on risk reduction of inpatient suicide for patients with schizophrenia who are compulsorily admitted compared with voluntarily admitted controls. Clinicians should be more alert for the prevention of inpatient suicide among patients with schizophrenia and consider the close monitoring of inpatient suicide risk in the first week of admission.
本研究旨在分析 2007 年至 2013 年间精神分裂症住院患者的住院自杀风险，并确定可能的风险因素。
我们进行了一项全国性的基于人群的队列研究，纳入了 2038 名首次强制住院的精神科住院患者，将其与 8152 名自愿住院的对照者相匹配。仅纳入精神分裂症患者进行研究。我们使用来自台湾全民健康保险数据库 2005 年的数据，该数据库涵盖了来自台湾全体受益人的 100 万名随机抽样者。
在随访期间，强制组和对照组分别观察到 23 例和 75 例住院自杀事件。Kaplan-Meier 曲线显示，强制和自愿入院患者的住院自杀累积发生率无显著差异（对数秩检验，p=0.206）。
我们的结果表明，与自愿入院的对照者相比，强制入院对降低强制入院的精神分裂症患者住院自杀风险没有保护作用。临床医生应更加警惕精神分裂症患者住院自杀的预防，并考虑在入院的第一周密切监测住院自杀风险。
