Kim Hyewon, Kim Yuwon, Shin Myung-Hee, Park Yoo-Jung, Park Hyung-Eun, Fava Maurizio, Mischoulon David, Park Mi Jin, Kim Eun Ji, Jeon Hong Jin
Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea.
Department of Data Science, Evidnet, Seongnam, South Korea.
Front Psychiatry. 2022 Sep 6;13:607892. doi: 10.3389/fpsyt.2022.607892. eCollection 2022.
Although people who attempted suicide tend to repeat suicide attempts, there is a lack of evidence on the association between psychiatric service factors and suicide reattempt among them.
We used a nationwide, population-based medical record database of South Korea to investigate the use of psychiatric services before and after the index suicide attempt and the association between psychiatric service factors after the index suicide attempt with the risk of suicide reattempt.
Among 5,874 people who had attempted suicide, the all-cause mortality within 3 months after the suicide attempt was 11.6%. Among all subjects who attempted suicide, 30.6% of them had used psychiatric services within 6 months before the suicide attempt; 43.7% of them had used psychiatric services within 3 months after the suicide attempt. Among individuals who had visited clinics following attempted suicide, the cumulative incidence of suicide reattempt over a mean follow-up period of 5.1 years was 3.4%. About half of suicide reattempts occurred within 1 year after the index suicide attempt. Referral to psychiatric services within 7 days was associated with a decreased risk of suicide reattempt (adjusted hazard ratio, 0.51; 95% confidence intervals, 0.29-0.89).
An early psychiatric referral within 1 week after a suicide attempt was associated with a decreased risk of suicide reattempt.
尽管有自杀企图的人往往会再次尝试自杀，但关于精神科服务因素与他们再次自杀企图之间的关联，目前缺乏证据。
我们使用了韩国一个基于全国人口的医疗记录数据库，来调查首次自杀企图前后精神科服务的使用情况，以及首次自杀企图后精神科服务因素与再次自杀企图风险之间的关联。
在5874名有自杀企图的人中，自杀企图后3个月内的全因死亡率为11.6%。在所有有自杀企图的受试者中，30.6%的人在自杀企图前6个月内使用过精神科服务；43.7%的人在自杀企图后3个月内使用过精神科服务。在自杀企图后就诊的个体中，平均随访5.1年期间再次自杀企图的累积发生率为3.4%。约一半的再次自杀企图发生在首次自杀企图后1年内。自杀企图后7天内转诊至精神科服务与再次自杀企图风险降低相关（调整后的风险比，0.51；95%置信区间，0.29 - 0.89）。
自杀企图后1周内尽早转诊至精神科与再次自杀企图风险降低相关。
