National Health Information Systems Unit, Health Research Board, Grattan House, Dublin 2 D02 H638, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland (RCSI), Lower Mercer Street, Dublin 2 D02 DH60, Ireland; Data Science Centre, Division of Population Health Sciences, RCSI, St Stephens Green, Dublin 2 D02 VN51, Ireland.
School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland (RCSI), Lower Mercer Street, Dublin 2 D02 DH60, Ireland.
J Affect Disord. 2022 Jun 1;306:80-89. doi: 10.1016/j.jad.2022.03.030. Epub 2022 Mar 17.
Suicide by drug poisoning is potentially preventable; however, evidence on associated risk factors by sex is limited.
To assist in understanding how individual and social contextual factors, and specific drugs, influence risk of suicide compared to non-suicide drug poisoning deaths, and how this differs by sex.
Data were extracted from the National Drug-Related Deaths Index. Analysis included univariable and multivariable logistic regression to estimate unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) for factors associated with suicide drug poisoning deaths (SDPD) (primary outcome) compared with non-suicide drug poisoning deaths (NSDPD) and stratified by sex.
SDPD accounted for 240 (22%) of 1114 poisoning deaths, the majority among men (n = 147, 61%). Increasing age, mental ill health (AOR 7.85, 95% CI: 5.46-11.28), chronic pain (AOR 5.57, 95% CI: 3.28-9.46), and history of previous overdose (AOR 5.06, 95% CI: 3.39-7.56) were associated with increased odds of SDPD, with similar results for both sexes. The main drugs associated with SDPD were non-opioid analgesics (OR 4.06 [95% CI 2.66-6.18]), antipsychotics (OR 2.42 [95% CI 1.63-3.60]) and antidepressants (OR 2.18 [95% CI 1.59-2.97]). Pregabalin was associated with SDPD among women only.
Secondary analysis of coronial data on drug poisoning deaths therefore findings may not be relevant to suicide deaths in general.
Ongoing monitoring for signs of suicidal intent in individuals with mental illness, chronic pain, overdose, and/or prescribed mental health medications may identify individuals in need of additional intervention.
药物中毒自杀是可以预防的;然而,有关性别相关风险因素的证据有限。
旨在了解个体和社会环境因素以及特定药物如何影响自杀性药物中毒死亡(SDPD)的风险,以及这些因素如何因性别而异,从而帮助我们理解这一点。
从国家药物相关死亡指数中提取数据。分析包括单变量和多变量逻辑回归,以估计与 SDPD(主要结局)相关的因素的未调整和调整后的比值比(OR)和 95%置信区间(CI),并按性别分层。
SDPD 占 1114 例中毒死亡中的 240 例(22%),其中大多数发生在男性(n=147,61%)。年龄增长、精神健康不良(OR 7.85,95%CI:5.46-11.28)、慢性疼痛(OR 5.57,95%CI:3.28-9.46)和既往过量用药史(OR 5.06,95%CI:3.39-7.56)与 SDPD 的几率增加相关,两种性别均有类似结果。与 SDPD 相关的主要药物是非阿片类镇痛药(OR 4.06 [95%CI 2.66-6.18])、抗精神病药(OR 2.42 [95%CI 1.63-3.60])和抗抑郁药(OR 2.18 [95%CI 1.59-2.97])。普瑞巴林仅与女性的 SDPD 相关。
对药物中毒死亡的验尸数据进行二次分析,因此调查结果可能与一般自杀死亡无关。
对患有精神疾病、慢性疼痛、过量用药和/或开有精神健康药物的个体持续监测自杀意图迹象,可能会发现需要额外干预的个体。