Bojanić Lana, Turnbull Pauline, Ibrahim Saied, Flynn Sandra, Kapur Navneet, Appleby Louis, Hunt Isabelle M
National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK.
NIHR Greater Manchester Patient Safety Research Collaboration, Manchester, UK.
Lancet Reg Health Eur. 2024 Jun 28;44:100991. doi: 10.1016/j.lanepe.2024.100991. eCollection 2024 Sep.
Suicide-related internet use (SRIU) has been shown to be linked to suicide. However, there is limited research on SRIU among mental health patients, who are at 4 to 7 times increased risk of suicide compared to the general population. This study aims to address this gap by exploring the prevalence of SRIU among mental health patients who died by suicide in the UK and describing their characteristics.
The study was carried out as part of the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH). Data were collected on sociodemographic, clinical, suicide characteristics and engagement in SRIU of patients who died by suicide between 2011 and 2021. The study utilised a case-control design to compare patients who engaged in suicide-related internet use with those who did not.
The presence or absence of SRIU was known for 9875/17,347 (57%) patients; SRIU was known to be present in 759/9875 (8%) patients. The internet was most often used to obtain information on suicide methods (n = 523/759, 69%) and to visit pro-suicide websites (n = 250/759, 33%) with a significant overlap between the two (n = 152/759, 20%). Engaging in SRIU was present across all age groups. The case-control element of the study showed patients who were known to have engaged in SRIU were more likely to have been diagnosed with autism spectrum disorder (OR = 2.13, 95% CI: 1.43-3.18), have a history of childhood abuse (OR = 1.70, 95% CI: 1.36-2.13) and to have received psychological treatment (OR = 1.43, 95% CI: 1.18-1.74) than controls. Additionally, these patients were more likely to have died on or near a salient date (OR = 2.11, 95% CI: 1.61-2.76), such as a birthday or anniversary.
The findings affirm SRIU as a feature of suicide among patients of all ages and highlight that clinicians should inquire about SRIU during assessments. Importantly, as the most common type of SRIU can expand knowledge on suicide means, clinicians need to be aware of the association between SRIU and choice of methods. This may be particularly relevant for patients approaching a significant calendar event.
The Healthcare Quality Improvement Partnership.
与自杀相关的互联网使用（SRIU）已被证明与自杀有关。然而，针对心理健康患者的SRIU研究有限，与普通人群相比，他们的自杀风险增加了4至7倍。本研究旨在通过探索英国自杀身亡的心理健康患者中SRIU的患病率并描述其特征来填补这一空白。
该研究作为国家心理健康自杀与安全保密调查（NCISH）的一部分进行。收集了2011年至2021年间自杀身亡患者的社会人口统计学、临床、自杀特征以及SRIU参与情况的数据。该研究采用病例对照设计，比较参与与自杀相关互联网使用的患者和未参与的患者。
9875/17347（57%）名患者的SRIU情况已知；已知759/9875（8%）名患者存在SRIU。互联网最常被用于获取自杀方法信息（n = 523/759，69%）和访问支持自杀的网站（n = 250/759，33%），两者之间有显著重叠（n = 152/759，20%）。各年龄组均存在SRIU情况。研究的病例对照部分显示，已知参与SRIU的患者比对照组更有可能被诊断为自闭症谱系障碍（OR = 2.13，95%CI：1.43 - 3.18），有童年虐待史（OR = 1.70，95%CI：1.36 - 2.13），并接受过心理治疗（OR = 1.43，95%CI：1.18 - 1.74）。此外，这些患者在重要日期或其附近死亡的可能性更大（OR = 2.11，95%CI：1.61 - 2.76），如生日或纪念日。
研究结果证实SRIU是各年龄段患者自杀的一个特征，并强调临床医生在评估过程中应询问SRIU情况。重要的是，由于最常见的SRIU类型可能会增加对自杀手段的了解，临床医生需要意识到SRIU与自杀手段选择之间的关联。这对于接近重要日历事件的患者可能尤为相关。
医疗质量改进伙伴关系。
