Alsén M, Ekedahl A, Löwenhielm P, Niméus A, Regnéll G, Träskman-Bendz L
Department of Psychiatry, Lund University, Sweden.
Acta Psychiatr Scand. 1994 Apr;89(4):255-61. doi: 10.1111/j.1600-0447.1994.tb01510.x.
The purpose of this study was to investigate the prevalence of toxic agents in attempted and completed suicides. The purpose was also to explore the sources of the drugs taken by suicide attempters. Verbal information on drug intake was collected from 280 suicide attempters during 1987-1990 in the Lund-Orup catchment area. Information on the sources of the drugs was collected from 143 of these attempters. The study also includes toxicological screening from 73 fatal poisonings in southern Sweden during 1989. According to verbal information, the most common drugs used by suicide attempters were benzodiazepines (51%), analgesics (29%) and antidepressants (20%). In suicide attempters, diazepam and levomepromazine were reported more than expected from prescription data. Toxicological screenings of fatal poisonings showed that benzodiazepines were most common (55%), followed by analgesics (38%), mainly propoxyphene (29%) and antidepressants (30%), mainly amitriptyline (22%). Amitriptyline and diazepam were more commonly detected in completed suicides than expected from prescription data. The most common sources of drugs to attempted suicides were physicians, and especially psychiatrists. We therefore conclude that continuous information to physicians on drug overdose is important, and it is also important to introduce alternative strategies to prevent suicidal behaviour.
本研究的目的是调查自杀未遂和自杀死亡案例中有毒物质的流行情况。其目的还在于探究自杀未遂者所服用药物的来源。1987年至1990年期间，在隆德 - 奥鲁普集水区从280名自杀未遂者那里收集了关于药物摄入的口头信息。从其中143名自杀未遂者那里收集了关于药物来源的信息。该研究还包括对1989年瑞典南部73例致命中毒案例的毒理学筛查。根据口头信息，自杀未遂者最常使用的药物是苯二氮䓬类药物（51%）、镇痛药（29%）和抗抑郁药（20%）。在自杀未遂者中，地西泮和左美丙嗪的报告使用情况高于处方数据预期。致命中毒案例的毒理学筛查显示，苯二氮䓬类药物最为常见（55%），其次是镇痛药（38%），主要是丙氧芬（29%）和抗抑郁药（30%），主要是阿米替林（22%）。在自杀死亡案例中，阿米替林和地西泮的检测频率高于处方数据预期。自杀未遂者最常见的药物来源是医生，尤其是精神科医生。因此，我们得出结论，持续向医生提供关于药物过量的信息很重要，引入替代策略以预防自杀行为也很重要。
