Allebeck P, Allgulander C, Fisher L D
Karolinska Institute, Huddinge University Hospital, Sweden.
BMJ. 1988 Jul 16;297(6642):176-8. doi: 10.1136/bmj.297.6642.176.
Suicide seems to be increasing in young people in various countries and causes the greatest loss of years of life under the age of 65 in the Swedish population. Data from a national survey of 50,465 conscripts in Sweden were used in a prospective follow up study to assess personality and behavioural predictors of suicide in young men. Altogether 247 completed suicides occurred in the cohort during 13 years' follow up. Baseline data on social conditions, psychological assessments, and psychiatric diagnoses of the conscripts were entered into a Cox regression model with suicide as the outcome variable. Several early indicators of antisocial personality (poor emotional control, contact with a child welfare authority or the police, and lack of friends) were strongly predictive of suicide. None of the few conscripts who had a diagnosis of schizophrenia or affective psychosis committed suicide. A diagnosis of neurosis was associated with a twofold increase in the suicide rate and personality disorder with a threefold increase. Although the risk of suicide is difficult to assess in an unselected population owing to the low base rate of suicide, the predictors identified in the study may help to identify those at high risk in units where people with deviant behaviour and personality disorders cluster.
在各个国家，年轻人的自杀率似乎都在上升，在瑞典人口中，自杀导致65岁以下人群寿命损失最为惨重。瑞典一项对50465名应征入伍者的全国性调查数据被用于一项前瞻性随访研究，以评估年轻男性自杀的人格和行为预测因素。在13年的随访期间，该队列中总共发生了247起自杀事件。应征入伍者的社会状况、心理评估和精神科诊断的基线数据被纳入以自杀为结局变量的Cox回归模型。反社会人格的几个早期指标（情绪控制差、与儿童福利机构或警方有接触以及缺乏朋友）对自杀具有很强的预测性。少数被诊断为精神分裂症或情感性精神病的应征入伍者均未自杀。神经症诊断与自杀率增加两倍相关，人格障碍与自杀率增加三倍相关。尽管由于自杀的基础发生率较低，在未经过筛选的人群中难以评估自杀风险，但该研究中确定的预测因素可能有助于在行为异常和人格障碍患者聚集的单位中识别出高风险人群。
