Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School.
Wakamiya Hospital.
J Nippon Med Sch. 2022;89(4):392-398. doi: 10.1272/jnms.JNMS.2022_89-405.
The number of suicides in Japan decreased during the period from 2012 through 2019. Because data on factors associated with this decline are limited, we conducted a retrospective longitudinal study of psychiatric diagnoses of serious suicide attempters before 2012 and after 2019.
Serious suicide attempters admitted to the critical care medicine (CCM) department of Nippon Medical School Hospital between 2006 and 2017 were included and classified as those before and after the suicide decline in 2012. Chi-square test and residual analysis were used to analyze changes in the proportion of suicide attempters among all patients admitted to CCM and to examine differences in the proportion of psychiatric diagnoses.
The proportion of suicide attempters among CCM hospitalized patients decreased overall (χ (1) =18.29, p<.01). The proportion of psychiatric diagnoses changed significantly (χ (8) =62.21, p<0.001); specifically, it decreased for schizophrenia (residual: -2.28), depressive disorders (residual: -5.39), persistent mood disorders (residual: -3.58), and reaction to stress disorders (residual: -2.73). Depressive disorders decreased and had a large contribution ratio in both sexes.
The decrease in the proportion of attempted suicides among patients admitted to CCM was consistent with the decline in suicides in Japan. Analysis by psychiatric diagnosis confirmed a significant decrease in the proportion of suicide attempts associated with depressive disorders, schizophrenia, and reaction to stress disorders, which were the most common disorders associated with attempted suicide. Depressive disorders made the greatest contribution to the reduction in suicide attempts.
日本的自杀人数在 2012 年至 2019 年期间有所下降。由于与这一下降相关的数据有限，我们对 2012 年之前和之后的严重自杀未遂者的精神科诊断进行了回顾性纵向研究。
纳入 2006 年至 2017 年期间在日本医科大学医院重症监护医学（CCM）科住院的严重自杀未遂者，并将其分为 2012 年自杀人数下降前后两组。采用卡方检验和残差分析来分析 CCM 住院患者中自杀未遂者的比例变化，并检查精神科诊断比例的差异。
CCM 住院患者中自杀未遂者的比例总体下降（χ（1）=18.29，p<.01）。精神科诊断的比例发生显著变化（χ（8）=62.21，p<0.001）；具体而言，精神分裂症（残差：-2.28）、抑郁障碍（残差：-5.39）、持续性心境障碍（残差：-3.58）和应激相关障碍（残差：-2.73）的比例下降。抑郁障碍在两性中均减少，且具有较大的贡献比。
CCM 住院患者中自杀未遂比例的下降与日本自杀人数的下降相一致。通过精神科诊断分析证实，与抑郁障碍、精神分裂症和应激相关障碍相关的自杀未遂比例显著下降，这些障碍是与自杀未遂最常见的相关障碍。抑郁障碍对自杀未遂减少的贡献最大。
