Stone Deborah M, Crosby Alex E
Division of Violence Prevention (DVP), National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
Am J Lifestyle Med. 2014;8(6):404-420. doi: 10.1177/1559827614551130. Epub 2014 Oct 16.
Suicide is a public health problem affecting people across the lifespan. It is currently the 10th leading cause of death, with rates having remained relatively flat for the past century. This article summarizes the problem of suicide and suicidal behavior along with suicide prevention efforts in the United States. Part 1 provides an overview of the epidemiology of suicide, including groups most at risk of suicide and suicidal behavior. Part 2 provides a review of common risk factors, organized by developmental life stage. A brief discussion of the lesser well-researched area of protective factors follows. Part 3 provides an overview of suicide prevention today, including the major types of prevention strategies, their successes, including means restriction, quality improvement in behavioral services, and comprehensive programs; and limitations to date, such as a lack of evidence for impact on actual deaths or behavior, small sample sizes, and low base rates. Finally, part 4 discusses challenges and future directions with an eye toward the great many opportunities that exist for prevention.
自杀是一个影响全生命周期人群的公共卫生问题。它目前是第十大死因,在过去一个世纪里,自杀率一直相对平稳。本文总结了美国的自杀问题、自杀行为以及自杀预防措施。第一部分概述了自杀的流行病学,包括自杀和自杀行为风险最高的群体。第二部分按生命发展阶段对常见风险因素进行了综述。随后简要讨论了研究较少的保护因素领域。第三部分概述了当今的自杀预防措施,包括主要的预防策略类型、它们的成效(包括手段限制、行为服务质量改善和综合项目)以及迄今为止存在的局限性(例如缺乏对实际死亡或行为影响的证据、样本量小和基础率低)。最后,第四部分着眼于存在大量预防机会,讨论了挑战和未来方向。