Inoue Keisuke, Otsuka Kotaro, Onishi Hideki, Cho Yoshinori, Shiraishi Masaki, Narita Kenji, Kawanishi Chiaki
Psychiatric Center, Yokohama City University Medical Center, 2 4-57, Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
Department of Neuropsychiatry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
Asian J Psychiatr. 2020 Feb;48:101908. doi: 10.1016/j.ajp.2019.101908. Epub 2019 Dec 17.
Suicide is a major cause of death among inpatients with schizophrenia. However, there are only a limited number of surveys of suicide among such patients, especially in Asia. Therefore, we conducted a multi-institutional survey on suicide death among inpatients with schizophrenia in Japan. We investigated the characteristics of patients with schizophrenia who died by suicide during hospitalization in psychiatric wards, and simultaneously, those of patients with depression. Forty-five suicides of patients with schizophrenia occurred in 27 hospitals, and 46 suicides of patients with depression occurred in 33 hospitals. Hanging was the most common suicide method in both diagnostic groups. More than half of the patients with schizophrenia had histories of suicide attempts, although there was no significant difference in previous suicide attempts or self-harm between both diagnostic groups. Medical staff should confirm whether inpatients with schizophrenia have such histories. In this study, there was no significant difference in characteristics between inpatients with schizophrenia or depression. In order to prevent suicides of patients with schizophrenia during hospitalization, nonspecific suicide attempt prevention needs to be undertaken, such as ensuring comprehension of the general risk factors of suicide among medical staff.
自杀是精神分裂症住院患者的主要死因。然而，针对此类患者的自杀调查数量有限，尤其是在亚洲。因此，我们在日本开展了一项关于精神分裂症住院患者自杀死亡情况的多机构调查。我们调查了在精神科病房住院期间自杀死亡的精神分裂症患者的特征，同时也调查了抑郁症患者的特征。27家医院中有45例精神分裂症患者自杀，33家医院中有46例抑郁症患者自杀。上吊是两个诊断组中最常见的自杀方式。超过一半的精神分裂症患者有自杀未遂史，尽管两个诊断组在既往自杀未遂或自我伤害方面没有显著差异。医护人员应确认精神分裂症住院患者是否有此类病史。在本研究中，精神分裂症患者和抑郁症患者在特征上没有显著差异。为防止精神分裂症患者在住院期间自杀，需要采取非特异性的自杀未遂预防措施，例如确保医护人员了解自杀的一般风险因素。
