Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China.
The Centre for Innovation in Mental and Physical Health and Clinical Treatment, Deakin University, Geelong, Australia; Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
J Affect Disord. 2021 Mar 1;282:707-711. doi: 10.1016/j.jad.2020.12.132. Epub 2020 Dec 28.
The estimated global burden of suicide is almost 1 million deaths per year, representing 57% of all violent deaths worldwide. In order to better identify at risk individuals and develop effective prevention strategies at the population level, a comprehensive understanding of the biological, psychological and social risk factors is required.
Data from the National Health Interview Survey (1997- 2004) were analyzed. Multivariable Cox proportional hazards regression models were used to compute hazard ratios (HRs) and accompanying 95% confidence intervals (CI).
During a mean 6.3 years of follow-up of 242, 952 people (1.56 million person-years), 180 deaths due to suicide occurred. Of 18 risk factors, eight revealed associations with suicide. Participants who had never been married (HR, 2.58; 95% CI, 1.44-4.62), current smokers (HR, 2.26; 1.49-3.43), current drinkers (HR, 1.93; 1.14-3.27]), participants with serious psychological distress (HR, 3.34; 1.81-6.18), and a history of emphysema (HR, 2.79; 1.18-6.59), liver disease (HR, 4.63; 2.10-10.20), kidney disease (HR, 2.26; 1.00-5.06) and cancer (HR, 2.18; 1.32-3.59) were at increased risk of completed suicide.
Due to the observational nature of this study, we cannot exclude the possibility of reverse or bi-directional causality.
This large, prospective cohort study identified a series of biopsychosocial risk factors that may have utility in suicide prevention.
全球自杀估计有 100 万人死亡，占全球所有暴力死亡的 57%。为了更好地识别高危人群，并在人群层面制定有效的预防策略，需要全面了解生物、心理和社会风险因素。
对 1997 年至 2004 年全国健康访谈调查的数据进行了分析。采用多变量 Cox 比例风险回归模型计算危险比（HR）及其 95%置信区间（CI）。
在对 242952 人的平均 6.3 年随访（156 万人年）中，有 180 人死于自杀。在 18 个危险因素中，有 8 个与自杀有关。从未结婚的参与者（HR，2.58；95%CI，1.44-4.62）、当前吸烟者（HR，2.26；95%CI，1.49-3.43）、当前饮酒者（HR，1.93；95%CI，1.14-3.27）、有严重心理困扰的参与者（HR，3.34；95%CI，1.81-6.18）、肺气肿史（HR，2.79；95%CI，1.18-6.59）、肝病（HR，4.63；95%CI，2.10-10.20）、肾病（HR，2.26；95%CI，1.00-5.06）和癌症（HR，2.18；95%CI，1.32-3.59）的参与者自杀风险增加。
由于这项研究是观察性的，我们不能排除反向或双向因果关系的可能性。
这项大型前瞻性队列研究确定了一系列可能对预防自杀有用的生物心理社会风险因素。
