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2008年至2017年三个中心儿童自杀风险因素分析。

An analysis of risk factors for child suicide in three centres from 2008 to 2017.

作者信息

Olds Kelly L, Tse Rexson, Stables Simon, Baker Andrew M, Hird Kathryn, Langlois Neil E, Byard Roger W

机构信息

Clinpath Pathology, Mile End, Adelaide, Australia.

LabPLUS, Auckland City Hospital, Auckland, New Zealand.

出版信息

Med Sci Law. 2025 Jul;65(3):221-226. doi: 10.1177/00258024241274914. Epub 2024 Aug 23.

Abstract

As a part of a study of suicide in children aged 17 years and under in three centers-Hennepin County in the United States (US), Auckland in New Zealand (NZ), and South Australia in Australia (AUS) from 2008 to 2017 it was decided to characterize potential risk factors and to determine whether these differed by jurisdiction. Reviewed data included a history of psychiatric illness, symptoms prior to suicide, events preceding suicide, previous suicidal ideation or suicide attempts, and communication of suicidal intent. The most common events preceding suicide were arguments with family/friends and relationship issues; in addition depression with or without expressed suicidal ideation, self-harming behavior, sadness, distress, drug/substance abuse, and anorexia were documented. Suicidal intent was on occasion communicated via technological means. In 79.5% of cases in South Australia decedents had a previously diagnosed psychiatric illness, with 62% in Hennepin County. This compared to a much lower proportion of cases in Auckland (23.8%). Whether this reflects more limited access to psychiatric services or a reluctance to seek support and therapy in Auckland is unclear. It does, however, demonstrate that risk factors for child suicide are not uniform among communities and so extrapolation of data from one area to another may not be appropriate. Disturbingly parents/carers were not aware of the decedent's suicidal intent in 84-87.2% of cases.

摘要

作为一项对2008年至2017年期间美国(US)亨内平县、新西兰(NZ)奥克兰和澳大利亚(AUS)南澳大利亚三个地区17岁及以下儿童自杀情况研究的一部分,研究决定对潜在风险因素进行特征描述,并确定这些因素在不同司法管辖区是否存在差异。审查的数据包括精神疾病史、自杀前的症状、自杀前的事件、既往自杀意念或自杀未遂情况以及自杀意图的传达。自杀前最常见的事件是与家人/朋友的争吵和关系问题;此外,记录了伴有或不伴有明确自杀意念的抑郁症、自残行为、悲伤、痛苦、药物/物质滥用和厌食症。自杀意图有时通过技术手段传达。在南澳大利亚79.5%的案例中,死者此前被诊断患有精神疾病,在亨内平县这一比例为62%。相比之下,奥克兰的案例比例要低得多(23.8%)。这是否反映出奥克兰获得精神科服务的机会更有限,或者是不愿寻求支持和治疗,尚不清楚。然而,这确实表明儿童自杀的风险因素在不同社区并不统一,因此将一个地区的数据外推到另一个地区可能并不合适。令人不安的是,在84% - 87.2%的案例中,父母/照顾者并未意识到死者的自杀意图。

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