Ge Dandan, Xia Yong, Zhang Zhonghua
Department of Evidence-Based Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Department of Education Management, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
BMJ Open. 2025 Jan 30;15(1):e088944. doi: 10.1136/bmjopen-2024-088944.
To assess the association between depression and suicide attempt (SA) by age and region.
Cross-sectional study.
First Affiliated Hospital of Wannan Medical College from January 2021 to January 2022.
Hospitalised patients.
SA was the primary outcome and data on SA was obtained from the electronic medical records of hospitalised patients.
In this study, data on inpatients of the First Affiliated Hospital of Wannan Medical College from January 2021 to January 2022 were extracted from the medical record system using the convenience sampling method. According to the exclusion criteria, 7593 eligible research subjects were obtained. Logistic regression analysis was used to assess the association between depression and SA, combining age and region. Subgroup analyses were carried out to assess the relationship between age, region and SA in depressed patients, after excluding non-depressed patients, and to inspect the interaction of age and region. Finally, further comparisons of the disparities in suicide patterns among different age groups and regional groups were made.
Among 7593 patients (3630 males), 655 (8.6%) patients with SA were observed. We found that depression was significantly associated with SA by age and region (all p<0.05). Specifically, depressed juveniles and adults had a higher risk of SA compared with non-depressed adults, and ORs (95% CIs) were 2.62 (1.59 to 4.30) and 1.67 (1.30 to 2.13), respectively. Furthermore, rural individuals with depression, urban individuals without depression and urban individuals with depression had a higher risk of SA compared with rural participants without depression, and ORs (95% CIs) were 1.60 (1.22 to 2.12), 1.29 (1.04 to 1.61) and 2.53 (1.83 to 3.49), respectively. In subgroup analyses, we further found that depression was strongly associated with SA in juveniles (OR 2.84, 95% CI 1.19 to 6.76, p=0.018) and urban patients (OR 1.67, 95% CI 1.15 to 2.40, p=0.006). Notably, the predominant methods of suicide among individuals with depression were the utilisation of sleeping pills or antidepressants.
Our study found individuals with depression are at higher risk of SA, especially juveniles and urban individuals. Effective integration of mental health and urban-rural services could mitigate the risk of suicide and contribute to better outcomes.
按年龄和地区评估抑郁症与自杀未遂（SA）之间的关联。
横断面研究。
2021年1月至2022年1月皖南医学院第一附属医院。
住院患者。
自杀未遂是主要结局，自杀未遂数据来自住院患者的电子病历。
本研究采用便利抽样法从病历系统中提取皖南医学院第一附属医院2021年1月至2022年1月住院患者的数据。根据排除标准，获得7593名符合条件的研究对象。采用逻辑回归分析，结合年龄和地区评估抑郁症与自杀未遂之间的关联。在排除非抑郁症患者后，进行亚组分析以评估抑郁症患者的年龄、地区与自杀未遂之间的关系，并检验年龄和地区的交互作用。最后，对不同年龄组和地区组之间自杀模式的差异进行进一步比较。
在7593例患者（3630例男性）中，观察到655例（8.6%）自杀未遂患者。我们发现，抑郁症与自杀未遂在年龄和地区方面均显著相关（所有p<0.05）。具体而言，与非抑郁症成年人相比，抑郁症青少年和成年人自杀未遂的风险更高，比值比（95%置信区间）分别为2.62（1.59至4.30）和1.67（1.30至2.13）。此外，与无抑郁症的农村参与者相比，患有抑郁症的农村个体、无抑郁症的城市个体和患有抑郁症的城市个体自杀未遂的风险更高，比值比（95%置信区间）分别为1.60（1.22至2.12）、1.29（1.04至1.61）和2.53（1.83至3.49）。在亚组分析中，我们进一步发现抑郁症与青少年自杀未遂（比值比2.84，95%置信区间1.19至6.76，p=0.018）和城市患者自杀未遂（比值比1.67，95%置信区间1.15至2.40，p=0.006）密切相关。值得注意的是，抑郁症患者自杀的主要方式是服用安眠药或抗抑郁药。
我们的研究发现抑郁症患者自杀未遂的风险更高，尤其是青少年和城市个体。有效整合心理健康和城乡服务可以降低自杀风险并带来更好的结果。
