Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Department of Public Health, Purdue University, 812 W State St, MTHW 214F, West Lafayette, IN, 47905, USA.
Soc Psychiatry Psychiatr Epidemiol. 2021 Oct;56(10):1791-1799. doi: 10.1007/s00127-020-01999-2. Epub 2021 Jan 3.
The purpose of this study was to examine whether the choice of means by persons who die by suicide is associated with a prior psychiatric diagnosis.
In this cross-sectional study, we analyzed suicide surveillance data from 18 states reporting to the National Violent Death Reporting System (NVDRS) between 2003 and 2014. NVDRS compiled data from multiple sources (e.g., coroner's reports, police reports, death certificates) on every violent death within reporting jurisdictions, including information on indicated psychiatric disorders and suicide means. We assessed whether the selected suicide means were associated with diagnoses using multinomial logistic regression.
Adjusted models suggested that, compared to decedents using firearms, those using poisoning were more likely to have each psychiatric disorder examined, including bipolar disorder (aOR: 2.17 [95% CI 2.03-2.32]), schizophrenia (aOR: 1.81 [1.61-2.04]), depression (aOR: 1.64 [1.58-1.70]), anxiety disorder (aOR: 1.46 [1.35-1.57]), and PTSD (aOR: 1.41 [1.22-1.64]). A far greater proportion of individuals who died from less common means (other than firearms, suffocation, or poisoning) had schizophrenia (aOR: 4.52 [4.00-5.11]).
Many existing and proposed means restriction interventions have focused on firearms. Additional focus on access to potential agents of poisoning (e.g., the type and quantity of medication administered to patients) among individuals with psychiatric diagnoses may be warranted.
本研究旨在探讨自杀者选择的自杀方式是否与先前的精神科诊断有关。
在这项横断面研究中，我们分析了国家暴力死亡报告系统（NVDRS）在 2003 年至 2014 年期间报告的 18 个州的自杀监测数据。NVDRS 从多个来源（如验尸官报告、警察报告、死亡证明）汇编了报告管辖范围内的每一起暴力死亡数据，包括指示性精神障碍和自杀方式的信息。我们使用多项逻辑回归评估所选自杀方式与诊断之间的关系。
调整后的模型表明，与使用枪支的死者相比，使用中毒的死者更有可能患有每种检查到的精神障碍，包括双相情感障碍（调整后的比值比[aOR]：2.17[95%置信区间[CI]：2.03-2.32]）、精神分裂症（aOR：1.81[1.61-2.04]）、抑郁症（aOR：1.64[1.58-1.70]）、焦虑障碍（aOR：1.46[1.35-1.57]）和创伤后应激障碍（aOR：1.41[1.22-1.64]）。死于不太常见方式（除枪支、窒息或中毒外）的人中有更大比例患有精神分裂症（aOR：4.52[4.00-5.11]）。
许多现有的和拟议的手段限制干预措施都集中在枪支上。对于有精神科诊断的个体，可能需要更多地关注获得潜在中毒药物的途径（例如，给予患者的药物类型和数量）。
