Mehanović Emina, Rosso Gianluca, Cuomo Gian Luca, Diecidue Roberto, Maina Giuseppe, Costa Giuseppe, Vigna-Taglianti Federica
Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy; Piedmont Centre for Drug Addiction Epidemiology, ASL TO3, Grugliasco, Turin, Italy.
Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy; Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.
J Psychiatr Res. 2023 May;161:19-26. doi: 10.1016/j.jpsychires.2023.02.035. Epub 2023 Mar 1.
Suicide attempters are at higher risk of death than the general population. The present study aims to investigate the excess of all-cause mortality and cause-specific mortality in a cohort of patients who have attempted suicide or had suicidal ideation compared with the general population.
The cohort included 826 patients residing in the Piedmont Region of Northwest Italy who were admitted to a hospital or emergency department for suicide attempts or suicidal ideation between 2010 and 2016. Mortality excesses of the study population compared to the general population were estimated by applying indirect standardization. Standardized Mortality Ratios and 95% Confidence Intervals were calculated for all-cause, and cause-specific, natural, and unnatural causes of death by gender and age.
During the 7 years of follow-up, 8.2% of the study sample died. The mortality of suicide attempters and ideators was significantly higher than that of the general population. Mortality was about twice than expected from natural causes, and 30 times than expected from unnatural causes. The mortality due to suicide was 85 times higher than that of the general population, with an excess of 126 times for females. The SMRs for all-cause mortality decreased with increasing age.
Patients who access hospitals or emergency departments for suicide attempts or suicidal ideation are a frail group at high risk of dying from natural or unnatural causes. Clinicians should pay special attention to the care of these patients, and public health and prevention professionals should develop and implement appropriate interventions to timely identify individuals at higher risk for suicide attempts and suicidal ideation and provide standardized care and support services.
自杀未遂者的死亡风险高于普通人群。本研究旨在调查与普通人群相比，有自杀未遂或自杀意念的患者队列中的全因死亡率和特定原因死亡率的超额情况。
该队列包括2010年至2016年间因自杀未遂或自杀意念入住意大利西北部皮埃蒙特地区医院或急诊科的826名患者。通过应用间接标准化来估计研究人群与普通人群相比的死亡率超额情况。按性别和年龄计算全因、特定原因、自然和非自然死亡原因的标准化死亡率及95%置信区间。
在7年的随访期间，研究样本中有8.2%死亡。自杀未遂者和有自杀意念者的死亡率显著高于普通人群。自然原因导致的死亡率约为预期的两倍，非自然原因导致的死亡率约为预期的30倍。自杀导致的死亡率比普通人群高85倍，女性高出126倍。全因死亡率的标准化死亡率随年龄增长而降低。
因自杀未遂或自杀意念前往医院或急诊科的患者是一个脆弱群体，有因自然或非自然原因死亡的高风险。临床医生应特别关注这些患者的护理，公共卫生和预防专业人员应制定并实施适当的干预措施，以及时识别有更高自杀未遂和自杀意念风险的个体，并提供标准化的护理和支持服务。
