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严重自杀未遂的风险因素:急诊科中老年与青年未遂者之间的差异

Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department.

作者信息

Kim Dong Wook, Cho Seo Eun, Kang Jae Myeong, Woo Soo Kyun, Kang Seung-Gul, Yeon Byeong Kil, Cho Seong-Jin

机构信息

College of Medicine, Gachon University, Incheon, South Korea.

Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.

出版信息

Front Psychiatry. 2021 Jan 8;11:607811. doi: 10.3389/fpsyt.2020.607811. eCollection 2020.

Abstract

Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department. Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age <65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups. Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease ( < 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, = 0.023). In the younger group, old age ( = 0.090, < 0.001), male sex ( = -0.038, = 0.019), and impression of schizophrenia ( = 0.074, = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio ( = -0.045, = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale. Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

摘要

众所周知,老年人的自杀未遂情况比年轻人更为严重。尽管严重自杀未遂(SSA)在韩国具有重大的社会影响,但老年人严重自杀未遂的行为机制仍有待阐明。因此,我们调查了急诊科老年和年轻自杀未遂者中严重自杀未遂的风险因素。比较了因自杀未遂前往急诊科的老年人(年龄≥65岁)和年轻人(年龄<65岁)的人口统计学数据、临床信息以及使用风险救援评定量表得出的自杀严重程度。进行回归分析以确定这两组中严重自杀未遂的风险因素。在370名患者中,37名是老年人(10%;年龄74.41±6.78岁),更有可能患有其他内科疾病(<0.001),且自杀完成率更高(16.2%对5.4%,=0.023)。在年轻组中,高龄(=0.090,<0.001)、男性(=-0.038,=0.019)和精神分裂症印象(=0.074,=0.027)与较高的风险救援比率相关,人际压力状况与较低的风险救援比率相关(=-0.045,=0.006)。然而,在老年组中,风险救援评定量表的回归模型中没有变量具有统计学意义。年龄、男性、人际压力和精神分裂症印象等人口统计学和临床因素与年轻自杀未遂者的致死率相关。然而,在老年组中没有因素与严重自杀未遂相关。老年自杀的致死率可能存在不同的机制。

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