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在一个 440 万儿童的队列中,自杀未遂存在代际传递。

Intergenerational transmission of suicide attempt in a cohort of 4.4 million children.

机构信息

Copenhagen Research Center for Mental Health, Copenhagen, Denmark.

Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.

出版信息

Psychol Med. 2022 Oct;52(14):3202-3209. doi: 10.1017/S0033291720005310. Epub 2021 Apr 8.

Abstract

BACKGROUND

The association between suicide attempts (SAs) in parents and children is unclear, and risk indicators for intergenerational transmission remain undocumented. We aimed to assess this association, considering the child's developmental period at the time of parents' attempted suicide, and the parental relation.

METHODS

Using a prospective cohort design, nationwide population data were linked to the Psychiatric Central Register and National Patient Register for all individuals aged 10 years or older living in Denmark between 1980 and 2016. We assessed incidence rate ratios (IRRs) and cumulative hazards for children's first SA.

RESULTS

In a cohort of 4 419 651 children, 163 056 (3.7%) had experienced a parental SA. An SA was recorded among 6996 (4.3%) of the exposed children as opposed to 70112 (1.6%) in unexposed individuals. Higher rates were noted when a parental SA occurred during early childhood (0 ⩽ age < 2) [IRR, 4.7; 95% confidence interval (CI) 4.2-5.4] late childhood (6 ⩽ age < 13) (IRR, 3.6; 95% CI 3.4-3.8) when compared to those unexposed. Children exposed prior to age 2 had the highest rates of all sub-groups when reaching age 13-17 (IRR, 6.5; 95% CI 6.0-7.1) and 18-25 years (IRR, 6.8; 95% CI 6.2-7.4). Maternal SA (IRR, 3.4; 95% CI 3.2-3.5) was associated with higher rates than paternal (IRR, 2.8; 95% CI 2.7-2.9).

CONCLUSION

Parental SA was associated with children's own SA. Exposure during early developmental stages was associated with the highest rates. Early preventive efforts are warranted as is monitoring of suicide risk in the children from age 13.

摘要

背景

父母自杀未遂(SA)与子女之间的关联尚不清楚,代际传递的风险指标仍未记录。我们旨在评估这种关联,同时考虑父母试图自杀时孩子的发育阶段以及父母关系。

方法

使用前瞻性队列设计,将全国人口数据与丹麦 1980 年至 2016 年间所有 10 岁及以上人群的精神病中央登记处和国家患者登记处进行链接。我们评估了儿童首次自杀未遂的发生率比(IRR)和累积风险。

结果

在一个包含 4419651 名儿童的队列中,有 163056 名(3.7%)儿童的父母经历过 SA。暴露组中有 6996 名(4.3%)儿童记录到 SA,而未暴露组中有 70112 名(1.6%)儿童记录到 SA。当父母的 SA 发生在儿童早期(0 ⩽ 年龄 < 2)[IRR,4.7;95%置信区间(CI)4.2-5.4]或儿童晚期(6 ⩽ 年龄 < 13)时,记录到的比率更高[IRR,3.6;95%CI 3.4-3.8]与未暴露的儿童相比。与其他亚组相比,2 岁前暴露的儿童在达到 13-17 岁[IRR,6.5;95%CI 6.0-7.1]和 18-25 岁[IRR,6.8;95%CI 6.2-7.4]时的 SA 发生率最高。与父亲相比,母亲的 SA(IRR,3.4;95%CI 3.2-3.5)与更高的比率相关,而父亲的 SA(IRR,2.8;95%CI 2.7-2.9)。

结论

父母的 SA 与子女自身的 SA 有关。暴露于早期发育阶段与最高的发病率相关。需要早期采取预防措施,并在儿童 13 岁时监测自杀风险。

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