Takeuchi Takashi, Okumura Yasuyuki, Ichikura Kanako
Section of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8519,
Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo 156-8506, Japan.
Acta Med Okayama. 2020 Feb;74(1):49-52. doi: 10.18926/AMO/57952.
The use of alcohol or drug(s) prior to self-injury is a possible inducing factor for suicidal self-injuries among patients with adjustment disorder. We analyzed the cases of 175 individuals who were admitted to the intensive care unit (ICU) of Tokyo Medical and Dental University Medical Hospital for suicidal self-injury to determine whether alcohol consumption or an excessive use of prescribed psychotropic medications prior to self-injury is more common in patients with adjustment disorder. During a 7-year period (July 2006 to June 2013) following their deliberate self-injuries, 971 patients were admitted to the ICU. Our study sample (n=175) was restricted to patients with adjustment disorder (n=48), major depressive disorder (n=90), or schizophrenia (n=37). The outcome variable was alcohol consumption or excessive use of medications prior to suicidal self-injury. A logistic regression analysis revealed that the patients with adjustment disorder more commonly showed alcohol consumption or excessive medication use prior to their suicidal self-injury compared to those with schizophrenia (odds ratio: 8.10; 95%CI: 2.97-24.60). To inhibit suicidal self-injury among patients with adjustment disorder, it is important to continue efforts to provide psychoeducation about alcohol use and to instruct the patients to take their prescribed medication(s) only as directed by their physician.
在自我伤害之前使用酒精或药物是适应障碍患者自杀性自我伤害的一个可能诱发因素。我们分析了175名因自杀性自我伤害而入住东京医科齿科大学医学医院重症监护病房(ICU)的患者病例,以确定在自我伤害前饮酒或过量使用处方精神药物在适应障碍患者中是否更为常见。在他们故意自我伤害后的7年期间(2006年7月至2013年6月),971名患者入住了ICU。我们的研究样本(n = 175)仅限于适应障碍患者(n = 48)、重度抑郁症患者(n = 90)或精神分裂症患者(n = 37)。结果变量是自杀性自我伤害前饮酒或药物过量使用情况。逻辑回归分析显示,与精神分裂症患者相比,适应障碍患者在自杀性自我伤害前更常出现饮酒或药物过量使用情况(优势比:8.10;95%置信区间:2.97 - 24.60)。为抑制适应障碍患者的自杀性自我伤害,持续努力提供关于饮酒的心理教育并指导患者仅按医生指示服用处方药物非常重要。