[自开展“VigilanS”行动以来,北加莱海峡地区自杀死亡率的首次变化趋势]
[First trends of change in mortality by suicide in Nord-Pas-de-Calais since VigilanS].
作者信息
Duhem S, Dambry S, Marchand E, Creton A, Debien C, Hedouin V, Vaiva G
机构信息
Inserm, centre d'investigation clinique, CHU de Lille, 59000 Lille, France.
SCA-Lab - sciences cognitives et sciences affectives, CNRS UMR 9193, pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, Université de Lille, CHU de Lille, 59000 Lille, France.
出版信息
Encephale. 2019 Jan;45 Suppl 1:S38-S41. doi: 10.1016/j.encep.2018.09.008. Epub 2018 Nov 10.
INTRODUCTION
In terms of suicide prevention, population-based prevention devices often struggle to demonstrate an effect in terms of reducing suicidal acts of suicide, often focusing on the evolution of the number of suicide attempts, on time too short to statistically interpret changes in mortality. The consolidated figures for mortality in France are provided by the CepiDC with a delay of approximately three years. We therefore had to try to work with an approximation of the phenomenon, and we tested the proxy value of the enumeration of corpses, body examinations and medico-legal autopsies for suicide by the forensic doctors of the Nord-Pas-de-Calais region in France. In parallel, we conducted a comprehensive mortality study for 2016 in the VigilanS cohort.
METHOD
By measuring the evolution of the number of body lifts for suicide by the Department of Forensic Medicine of the region, for the 3 years before VigilanS (2012-2014) compared to the 3 years since VigilanS (2015-2017). The deaths of patients of the VigilanS cohort were identified by calling the city halls of birth and domicile of all patients integrating the device in 2016. The cause of death was then characterized by contact of the attending physician.
RESULTS
We observe an average decrease in suicide mortality of 9.9% (-12% for men, +0.3% for women). The exhaustive analysis of suicide mortality in the VigilanS cohort in 2016 found 19 deaths, of which 14 by suicide, or 0.4% of patients. This observed mortality rate in the VigilanS cohort in 2016 is significantly below the expected threshold in the literature (1 to 2% in the year following TS).
CONCLUSION
It seems possible to reach the 2020 target for a 10% decrease in suicidal behavior in industrialized countries by 2020. The VigilanS device could therefore be protective in terms of suicide mortality.
引言
在自杀预防方面,基于人群的预防措施往往难以证明在减少自杀行为方面的效果,通常关注自杀未遂数量的变化,时间过短以至于无法从统计学角度解读死亡率的变化。法国的综合死亡率数据由法国疾病预防控制中心(CepiDC)提供,延迟约三年。因此,我们不得不尝试对这一现象进行近似研究,并测试法国北部加来海峡地区法医对尸体清点、尸体检查和法医解剖进行自杀枚举的替代价值。同时,我们对VigilanS队列2016年的综合死亡率进行了研究。
方法
通过测量该地区法医学部门在VigilanS之前3年(2012 - 2014年)与VigilanS之后3年(2015 - 2017年)自杀尸体搬运数量的变化。通过联系2016年纳入该项目的所有患者的出生地和户籍所在地市政厅来确定VigilanS队列患者的死亡情况。然后由主治医生确定死因。
结果
我们观察到自杀死亡率平均下降了9.9%(男性下降12%,女性上升0.3%)。对2016年VigilanS队列自杀死亡率的详尽分析发现19例死亡,其中14例为自杀,占患者的0.4%。2016年VigilanS队列观察到的死亡率显著低于文献中的预期阈值(自杀未遂后一年为1%至2%)。
结论
到2020年,工业化国家有可能实现将自杀行为减少10%的2020年目标。因此,VigilanS项目在自杀死亡率方面可能具有保护作用。