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韩国基于全国人口的巢式病例对照研究:各年龄组患有国际疾病分类第十版(ICD-10)疾病的社区个体的自杀死亡风险

Risks of Completed Suicide of Community Individuals with ICD-10 Disorders Across Age Groups: A Nationwide Population-Based Nested Case-Control Study in South Korea.

作者信息

Na Eun Jin, Lee Hyewon, Myung Woojae, Fava Maurizio, Mischoulon David, Paik Jong-Woo, Hong Jin Pyo, Choi Kwan Woo, Kim Ho, Jeon Hong Jin

机构信息

Korea Psychological Autopsy Center (KPAC), Seoul, Republic of Korea.

Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

出版信息

Psychiatry Investig. 2019 Apr;16(4):314-324. doi: 10.30773/pi.2019.02.19. Epub 2019 Apr 24.

Abstract

OBJECTIVE

Suicide is the leading cause of death in 10-39-year-olds in South Korea, and the second highest rate among the OECD countries. However, few studies have investigated the particularity of completed suicide in South Korea.

METHODS

Study subjects consisted of 2,838 suicide cases and 56,758 age and sex matched living controls from a national representative sample of 1,025,340 South Koreans. They were obtained from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) with follow-up up to 12 years. We obtained information on primary diagnosis of any ICD-10 disorder along with suicide cases during their lifetime.

RESULTS

Among ICD-10 disorders, depression was the most common disorder (19.10%, n=542), found in victims of completed suicides except for common medical disorders such as hypertensive crisis, respiratory tract infection or arthropathies. After adjusting for sex, age, economic status, disability, and disorders, schizophrenia showed the strongest association with suicide (AOR: 28.56, 95% CI: 19.58-41.66) among all ICD-10 disorders, followed by psoriasis, multiple body injury, epilepsy, sleep disorder, depression, and bipolar disorder. For age groups, ≤19 years was associated with anxiety disorder (AOR=80.65, 95% CI: 13.33-487.93), 20-34 years with epilepsy (AOR=134.92, 95% CI: 33.69-540.37), both 35-49 years (AOR=108.57, 95% CI: 37.17-317.09) and 50-65 years (AOR=189.41 95% CI: 26.59-1349.31), with schizophrenia, and >65 years (AOR=44.7, 95% CI: 8.93-223.63) with psoriasis.

CONCLUSION

Psychiatric and physical disorders carried greatly increased risks and numbers of suicides in South Korea. Schizophrenia was the strongest risk factor, especially 35-65 years, and depression was the most common in suicide victims among ICD-10 disorders in South Korea.

摘要

目的

自杀是韩国10至39岁人群的主要死因,在经合组织国家中自杀率排名第二。然而,很少有研究调查韩国自杀既遂的特殊性。

方法

研究对象包括2838例自杀病例和56758例年龄及性别匹配的在世对照,这些对象来自1025340名韩国人的全国代表性样本。数据来自韩国国民健康保险服务全国样本队列(NHIS-NSC),随访时间长达12年。我们获取了有关任何ICD-10疾病的初步诊断信息以及自杀病例一生中的相关情况。

结果

在ICD-10疾病中,抑郁症是最常见的疾病(19.10%,n = 542),除高血压危象、呼吸道感染或关节病等常见内科疾病外,在自杀既遂者中也有发现。在对性别、年龄、经济状况、残疾和疾病进行调整后,在所有ICD-10疾病中,精神分裂症与自杀的关联最强(比值比[AOR]:28.56,95%置信区间[CI]:19.58 - 41.66),其次是银屑病、多处身体损伤、癫痫、睡眠障碍、抑郁症和双相情感障碍。对于年龄组,≤19岁与焦虑症相关(AOR = 80.65,95% CI:13.33 - 487.93),20 - 34岁与癫痫相关(AOR = 134.92,95% CI:33.69 - 540.37),35 - 49岁(AOR = 108.57,95% CI:37.17 - 317.09)和50 - 65岁(AOR = 189.41,95% CI:26.59 - 1349.31)均与精神分裂症相关,>65岁与银屑病相关(AOR = 44.7,95% CI:8.93 - 223.63)。

结论

在韩国,精神疾病和躯体疾病导致自杀的风险和数量大幅增加。精神分裂症是最强的风险因素,尤其是在35至65岁人群中,而抑郁症是韩国ICD-10疾病中自杀受害者中最常见的疾病。

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