Rodway Cathryn, Tham Su-Gwan, Ibrahim Saied, Turnbull Pauline, Kapur Nav, Appleby Louis
National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, UK.
National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester; and Greater Manchester Mental Health NHS Foundation Trust, UK.
BJPsych Open. 2020 May 11;6(3):e49. doi: 10.1192/bjo.2020.33.
Worldwide suicide is commonest in young people and in many countries, including the UK, suicide rates in young people are rising.
To investigate the stresses young people face before they take their lives, their contact with services that could be preventative and whether these differ in girls and boys.
We identified a 3-year UK national consecutive case series of deaths by suicide in people aged 10-19, based on national mortality data. We extracted information on the antecedents of suicide from official investigations, primarily inquests.
Between 2014 and 2016, there were 595 suicides by young people, almost 200 per year; 71% were male (n = 425). Suicide rates increased from the mid-teens, most deaths occurred in those aged 17-19 (443, 74%). We obtained data about the antecedents of suicide for 544 (91%). A number of previous and recent stresses were reported including witnessing domestic violence, bullying, self-harm, bereavement (including by suicide) and academic pressures. These experiences were generally more common in girls than boys, whereas drug misuse (odds ratio (OR) = 0.54, 95% CI 0.35-0.83, P = 0.006) and workplace problems (OR 0.52, 95% CI 0.28-0.96, P = 0.04) were less common in girls. A total of 329 (60%) had been in contact with specialist children's services, and this was more common in girls (OR 1.86, 95% CI 1.19-2.94, P = 0.007).
There are several antecedents to suicide in young people, particularly girls, which are important in a multiagency approach to prevention incorporating education, social care, health services and the third sector. Some of these may also have contributed to the recent rise.
在全球范围内，自杀在年轻人中最为常见，在包括英国在内的许多国家，年轻人的自杀率正在上升。
调查年轻人在自杀前所面临的压力、他们与可能具有预防作用的服务机构的接触情况，以及这些情况在女孩和男孩中是否存在差异。
我们根据国家死亡数据，确定了一个为期3年的英国全国性10至19岁自杀死亡连续病例系列。我们从官方调查（主要是死因调查）中提取了关于自杀前因的信息。
2014年至2016年期间，有595名年轻人自杀，每年近200例；71%为男性（n = 425）。自杀率从十几岁中期开始上升，大多数死亡发生在17至19岁的人群中（443例，占74%）。我们获得了544例（91%）自杀前因的数据。报告了一些既往和近期的压力，包括目睹家庭暴力、欺凌、自残、丧亲（包括自杀丧亲）和学业压力。这些经历在女孩中通常比男孩更常见，而药物滥用（优势比（OR）=0.54，95%置信区间0.35 - 0.83，P = 0.006）和工作场所问题（OR 0.52，95%置信区间0.28 - 0.96，P = 0.04）在女孩中较少见。共有329例（60%）曾与儿童专科服务机构接触，这在女孩中更常见（OR 1.86，95%置信区间1.19 - 2.94，P = 0.007）。
年轻人自杀有多种前因，尤其是女孩，这在多机构预防方法中很重要，该方法包括教育、社会关怀、卫生服务和第三部门。其中一些因素可能也导致了近期自杀率的上升。
