Liu Xiang, Yang Xianmei, Wang Dan, Fan Ruoxin, Wang Rongke, Xiang Hu, Liu Jun, Liu Yuanyuan
West China School of Public Health and West China Fourth Hospital, Sichuan University, China.
The Third Hospital of Mianyang, Sichuan Mental Health Center, China.
Psychiatry Res. 2023 Apr;322:115108. doi: 10.1016/j.psychres.2023.115108. Epub 2023 Feb 12.
Excess mortality in people with severe mental illness (SMI) has been extensively reported. However, little is known about mortality due to natural causes and suicide and their risk factors among people with SMI in western China. The study was conducted to determine the risk factors of natural death and suicide among people with SMI in western China. A totoal of 20,195 SMI patients in western China derived from severe mental illness information system in Sichuan province (January 1, 2006, through July 31, 2018) were included in the cohort study. Mortality rates per 10,000 person-years of natural causes and suicide for patients were calculated with different characteristics. Fine-Gray competing risk model was used to identify risk factors of natural death and suicide. The mortality was 132.8 per 10,000 person-years for natural death and 13.6 per 10,000 person-years for suicide. Males, older age, divorced/widowed, poverty and no anti-psychotic treatment were significantly associated with natural death. Higher education and suicide attempt were strong risk factors of suicide. Risk factors were not shared across natural death and suicide among people with SMI in western China. Risk management and interventions for people with SMI should be tailored for specific causes of death.
严重精神疾病（SMI）患者的超额死亡率已有大量报道。然而，在中国西部，关于SMI患者自然死亡和自杀所致死亡率及其风险因素的了解却很少。本研究旨在确定中国西部SMI患者自然死亡和自杀的风险因素。队列研究纳入了来自四川省严重精神疾病信息系统（2006年1月1日至2018年7月31日）的总共20195名中国西部SMI患者。计算了不同特征患者每10000人年的自然死亡和自杀死亡率。采用Fine-Gray竞争风险模型确定自然死亡和自杀的风险因素。自然死亡的死亡率为每10000人年132.8例，自杀的死亡率为每10000人年13.6例。男性、年龄较大、离婚/丧偶、贫困和未接受抗精神病治疗与自然死亡显著相关。高等教育和自杀未遂是自杀的强烈风险因素。在中国西部，SMI患者自然死亡和自杀的风险因素并不相同。应对SMI患者的风险管理和干预措施应针对特定的死亡原因进行调整。
