Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan; Department of Acute Critical Care and Disaster Medicine, Graduate School of Tokyo Medical and Dental University, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
Am J Emerg Med. 2024 Jan;75:1-6. doi: 10.1016/j.ajem.2023.10.016. Epub 2023 Oct 20.
Although the prevalence of drug overdose has gradually increased worldwide, the risk factors associated with the recurrence of suicide attempts via drug overdose have not been well elucidated. In this study, we investigated the clinical course of patients with drug overdose and whether or not patients reattempted suicide via overdose, using telephone interviews, to evaluate the risk factors associated with overdose recurrence.
This prospective observational study enrolled patients who attempted suicide by drug overdose and were transferred to a tertiary emergency hospital in Japan between January 1, 2015 and July 30, 2021. Recurrence of overdose within 1 year of admission for overdose was designated as the primary outcome. Multivariable logistic regression analysis was performed to assess the independent risk factors for the recurrence of overdose. Furthermore, we compared the difference in the recurrence interval between patients with and without cohabitants using the log-rank test.
A total of 94 patients were identified, and recurrence of overdose was observed in 28 patients (29.8%). The median recurrence interval was 6.0 months [IQR (interquartile range), 4.0-7.0 months]. The recurrence rate was significantly higher in patients with a history of schizophrenia than that in patients without a history of schizophrenia (58.3% vs 25.6%, p = 0.048), and significantly lower in patients with cohabitants than that in patients without cohabitants (22.6% vs 43.8%, p = 0.015). The presence of a cohabitant was significantly associated with a longer recurrence interval (p = 0.049). The effect of psychiatric intervention during hospitalization and psychiatric visits after discharge could not be found in this study.
A history of schizophrenia was an independent risk factor for the recurrence of overdose, and the presence of a cohabitant was significantly associated with a lower risk of recurrence. Large-scale, long-term studies are required to confirm the results of this study.
尽管全球范围内药物过量的发生率逐渐增加,但与药物过量自杀再尝试相关的风险因素仍未得到充分阐明。在本研究中,我们通过电话访谈调查了药物过量患者的临床病程,以及患者是否再次通过药物过量自杀,以评估与药物过量再发相关的风险因素。
本前瞻性观察性研究纳入了 2015 年 1 月 1 日至 2021 年 7 月 30 日期间在日本一家三级急救医院因药物过量而尝试自杀并被转至该院的患者。入院后 1 年内再次发生药物过量被指定为主要结局。采用多变量逻辑回归分析评估药物过量再发的独立风险因素。此外,我们使用对数秩检验比较了有和无同居者患者的复发间隔差异。
共纳入 94 例患者,其中 28 例(29.8%)发生了药物过量再发。中位复发间隔为 6.0 个月[IQR(四分位间距),4.0-7.0 个月]。有精神分裂症病史的患者药物过量再发率显著高于无精神分裂症病史的患者(58.3%比 25.6%,p=0.048),有同居者的患者药物过量再发率显著低于无同居者的患者(22.6%比 43.8%,p=0.015)。有同居者与更长的复发间隔显著相关(p=0.049)。在本研究中,未发现住院期间的精神科干预和出院后的精神科随访对再发的影响。
精神分裂症病史是药物过量再发的独立风险因素,有同居者与较低的再发风险显著相关。需要开展大规模、长期研究来证实本研究的结果。