Tachikawa Hirokazu, Takahashi Sho, Nemoto Kiyotaka, Yonemoto Naohiro, Oda Hiroyuki, Miyake Yasufumi, Hirayasu Yoshio, Arai Tetsuaki, Kawanishi Chiaki
Department of Disaster and Community Psychiatry, Faculty of Medicine University of Tsukuba Tsukuba Japan.
Department of Psychiatry, Faculty of Medicine University of Tsukuba Tsukuba Japan.
PCN Rep. 2022 Apr 12;1(2):e7. doi: 10.1002/pcn5.7. eCollection 2022 Jun.
Risk factors for attempted suicide have been widely studied. However, there is limited evidence on predictive factors for suicide reattempts. We aimed to identify these in suicide attempters admitted to emergency departments.
This is the second analysis from a randomized controlled multicenter trial, ACTION-J. Patient characteristics were extracted from baseline demographic data and clinical data of participants. Predictive factors for a recurrent suicide attempt in each gender were examined using Cox proportional hazards regression analysis. Dependent variables were months from trial entry to the first reattempt. Independent variables were characteristics regarded as potential predictive factors.
The study included 914 adults (400 men and 514 women). A visit to a psychiatrist within a month of the suicide attempt was significantly associated with reattempts in men (hazard ratio [HR] 2.49, 95% confidence interval [CI] 1.21-5.25). Substance-related disorders (HR 3.65, 95% CI 1.16-7.9.60), drinking alcohol less than once per month (HR 0.42, 95% CI 0.17-0.88), previous suicide attempts (HR 2.28, 95% CI 1.40-3.87), and taking a drug overdose for the first suicide attempt (HR 1.82, 95% CI 1.14-3.01) were significantly associated with reattempts in women.
Our data highlight the importance of visits to a psychiatrist a short time before the first suicide attempt in men and substance-related disorder, previous suicide attempts, and drug overdose in the first suicide attempt in women as predictive factors for future suicide reattempts.
自杀未遂的风险因素已得到广泛研究。然而,关于自杀再未遂预测因素的证据有限。我们旨在确定急诊科收治的自杀未遂者中的这些因素。
这是一项随机对照多中心试验ACTION-J的二次分析。从参与者的基线人口统计学数据和临床数据中提取患者特征。使用Cox比例风险回归分析检查每种性别的复发性自杀未遂的预测因素。因变量是从试验入组到首次再未遂的月数。自变量是被视为潜在预测因素的特征。
该研究纳入了914名成年人(400名男性和514名女性)。自杀未遂后一个月内就诊于精神科医生与男性再未遂显著相关(风险比[HR]2.49,95%置信区间[CI]1.21-5.25)。物质相关障碍(HR 3.65,95% CI 1.16-7.960)、每月饮酒少于一次(HR 0.42,95% CI 0.17-0.88)、既往自杀未遂(HR 2.28,95% CI 1.40-3.87)以及首次自杀未遂时服用过量药物(HR 1.82,95% CI 1.14-3.01)与女性再未遂显著相关。
我们的数据强调了男性首次自杀未遂前不久就诊于精神科医生以及女性物质相关障碍、既往自杀未遂和首次自杀未遂时服用过量药物作为未来自杀再未遂预测因素的重要性。