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自杀前开具的疼痛和精神健康药物:基于人群的病例对照研究。

Prescribed pain and mental health medication prior to suicide: A population based case control study.

机构信息

Psychology Research Institute, Ulster University, Coleraine Campus BT52 1SA, United Kingdom.

Queen's Management School, Queen's University, Belfast BT9 5EE, United Kingdom.

出版信息

J Affect Disord. 2019 Mar 1;246:195-200. doi: 10.1016/j.jad.2018.12.018. Epub 2018 Dec 17.

Abstract

BACKGROUND

Information about prescription medications prior to death by suicide may help us understand the role of medications, illness and service contact in suicide.

AIMS

Through the use of a novel dataset, this study aims to provide an improved understanding of the relationships between pain medication and mental health medication, suicide and area level deprivation.

METHODS

Data was included on all deaths by suicide in NI (Northern Ireland) between 1/1/2012 and 31/12/2015. Each death was matched to 5 live controls, based on age (the closest match within 2 years) and gender, resulting in a dataset consisting of 6630 individuals. Four data sources were linked to obtain the final dataset.

RESULTS

Suicide linked with and deprivation, with a heightened risk of suicide for 9 months after last prescription of pain medication and for up to two years after last prescription of mental health medication. Odds ratios for death by suicide were strongest among those with the most recent prescriptions (within 0-3 months) (OR for death by suicide = 12.20 amongst those with mental health prescription medication; OR for death by suicide = 3.69 amongst those with pain medication). These figures support the associations between suicide and pain related conditions, and physical health difficulties. Recent prescriptions are particularly important.

LIMITATIONS

Received medication prescriptions may not have been taken as recommended.

CONCLUSIONS

Contact with a clinician to obtain a prescription may present opportunities for intervention. Suicide assessment (and evidence-based suicide specific treatments) may be important for people who are receiving prescribed medication, particularly for a mental illness.

摘要

背景

自杀前有关处方药物的信息可能有助于我们了解药物、疾病和服务接触在自杀中的作用。

目的

通过使用新的数据集,本研究旨在更好地理解疼痛药物和精神健康药物、自杀和地区贫困水平之间的关系。

方法

纳入了 2012 年 1 月 1 日至 2015 年 12 月 31 日期间在北爱尔兰发生的所有自杀死亡病例。每个死亡病例与 5 名年龄相近(2 年内最接近)且性别相同的存活对照相匹配,最终数据集包含 6630 人。共链接了四个数据源以获取最终数据集。

结果

自杀与贫困相关,在最后一次开具疼痛药物处方后的 9 个月和最后一次开具精神健康药物处方后的两年内,自杀风险增加。最近(0-3 个月内)开具处方的人自杀的可能性最高(有精神健康药物处方的人自杀的可能性为 12.20;有疼痛药物处方的人自杀的可能性为 3.69)。这些数据支持了自杀与疼痛相关疾病和身体健康问题之间的关联。最近的处方尤其重要。

局限性

所接受的药物处方可能并未按建议服用。

结论

为获得处方而与临床医生接触可能为干预提供机会。对于正在接受处方药物治疗的人,尤其是对于精神疾病患者,进行自杀评估(和基于证据的专门针对自杀的治疗)可能很重要。

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