Department of Child and Adolescent Psychiatry, North Lee North, Unit 9, St Stephen's Hospital, Glanmire, Cork, Ireland.
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Soc Psychiatry Psychiatr Epidemiol. 2020 Nov;55(11):1525-1533. doi: 10.1007/s00127-020-01911-y. Epub 2020 Jul 12.
There is limited research on the associations between factors relating to mental and physical health in people who died by suicide.
Consecutive suicide cases were included in a psychological autopsy study as part of the Suicide Support and Information System in southern Ireland. Chi-square tests and logistic regression analysis were used to examine factors associated with recorded presence or absence of mental and physical health problems.
The total sample comprised 307 suicide cases, the majority being male (80.1%). Sixty-five percent had a history of self-harm and 34.6% of these cases had not been seen or treated following previous self-harm, although most (80.3%) had a history of recent GP attendance. Mental health diagnoses were present in 84.8% of cases where this variable was documented, and among these, 60.7% had a history of substance misuse and 30.6% had physical health problems. Variables associated with mental illness included gender, older age, previous self-harm episode(s), and presence of drugs in toxicology at time of death. Variables associated with physical illness included older age, death by means other than hanging, and previous self-harm episode(s).
Different factors associated with suicide were identified among people with mental and physical illness and those with and without a diagnosis, and need to be taken into account in suicide prevention. The identified factors highlight the importance of integrated care for dual-diagnosis presentations, restricting access to means, and early recognition and intervention for people with high-risk self-harm.
关于与自杀者的精神和身体健康相关因素之间的关联,相关研究有限。
作为爱尔兰南部自杀支持和信息系统的一部分,连续自杀案例被纳入心理解剖研究。采用卡方检验和逻辑回归分析来检查与记录的精神和身体健康问题的存在或缺失相关的因素。
总样本包括 307 例自杀案例,其中大多数为男性(80.1%)。65%有自残史,其中 34.6%在自残后未接受过治疗或治疗,但大多数(80.3%)最近曾看过全科医生。在记录了这一变量的病例中,有 84.8%存在心理健康诊断,其中 60.7%有物质滥用史,30.6%有身体健康问题。与精神疾病相关的变量包括性别、年龄较大、以前的自残发作和死亡时毒理学检测到的药物。与身体健康问题相关的变量包括年龄较大、非上吊方式死亡和以前的自残发作。
在有精神和身体疾病的人群以及有和没有诊断的人群中,确定了与自杀相关的不同因素,需要在预防自杀中加以考虑。确定的因素突出了为双重诊断患者提供综合护理、限制获得手段的重要性,以及对高风险自残者的早期识别和干预。