Henriksson M M, Aro H M, Marttunen M J, Heikkinen M E, Isometsä E T, Kuoppasalmi K I, Lönnqvist J K
Department of Mental Health, National Public Health Institute, Helsinki, Finland.
Am J Psychiatry. 1993 Jun;150(6):935-40. doi: 10.1176/ajp.150.6.935.
The purpose of this study was to investigate the prevalence and comorbidity of current mental disorders defined by DSM-III-R among a random sample of suicide victims from a nationwide suicide population.
Using a psychological autopsy method, the authors collected comprehensive data on all suicide victims in Finland during 1 year. Retrospective axis I-III consensus diagnoses were assigned to 229 (172 male, 57 female) victims.
One or more diagnoses on axis I were made for 93% of the victims. The most prevalent disorders were depressive disorders (59%) and alcohol dependence or abuse (43%). The prevalence of major depression was higher among females (46%) than among males (26%). Alcohol dependence was more common among the males (39% versus 18% for females). A diagnosis on axis II was made for 31% and at least one diagnosis on axis III for 46% of the cases. Only 12% of the victims received one axis I diagnosis without any comorbidity.
The majority of suicide victims suffered from comorbid mental disorders. Comorbidity needs to be taken into account when analyzing the relationship between suicide and mental disorders and in planning treatment strategies for suicide prevention in clinical practice.
本研究旨在调查全国自杀人群中随机抽取的自杀受害者样本中，由《精神疾病诊断与统计手册第三版修订版》（DSM-III-R）定义的当前精神障碍的患病率及共病情况。
作者采用心理解剖法，收集了芬兰一年内所有自杀受害者的综合数据。对229名（172名男性，57名女性）受害者进行了回顾性的轴I至轴III共识诊断。
93%的受害者被诊断出轴I上有一种或多种疾病。最常见的疾病是抑郁症（59%）和酒精依赖或滥用（43%）。女性中重度抑郁症的患病率（46%）高于男性（26%）。酒精依赖在男性中更为常见（39%，女性为18%）。31%的病例被诊断出轴II上有疾病，46%的病例在轴III上至少有一项诊断。只有12%的受害者仅被诊断出一种轴I疾病且无任何共病情况。
大多数自杀受害者患有共病性精神障碍。在分析自杀与精神障碍之间的关系以及规划临床实践中预防自杀的治疗策略时，需要考虑共病情况。
