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全科医生与青少年自杀:初级保健的预防作用

General practitioners and young suicides: a preventive role for primary care.

作者信息

Appleby L, Amos T, Doyle U, Tomenson B, Woodman M

出版信息

Br J Psychiatry. 1996 Mar;168(3):330-3. doi: 10.1192/bjp.168.3.330.

Abstract

BACKGROUND

The suicide rate in young men, but not young women, is rising. One possible route to suicide prevention is through general practice but recent evidence suggests that young suicides are not likely to attend GP surgeries prior to death.

METHOD

We carried out a retrospective examination of general practice contacts by a 2-year sample of suicides under 35 years of age in the 12 health districts of Greater Manchester. In the 61 young suicides who were known to attend a GP in the three months before death, we recorded (a) the number of consultations each week in the three months before suicide; (b) sex differences in rates of and reasons for consultation; (c) frequency of recorded risk assessment at the last GP visit before suicide.

RESULTS

The number of GP visits increased significantly before death. A monthly increase was more evident in males, but the increase in the week before death was more marked in females. There was no sex difference in the rate of GP visits before suicide; both sexes were most likely to attend for psychological reasons. Significant suicide risk had been noted at none of the final GP visits.

CONCLUSIONS

There remains a potential role for GPs in preventing suicides by young people of both sexes. The recent increase in suicide by young males does not appear to be related to a lower rate of GP attendance before death. Future training of GPs in this area should focus on risk assessment.

摘要

背景

年轻男性而非年轻女性的自杀率正在上升。预防自杀的一条可能途径是通过全科医疗,但最近的证据表明,年轻自杀者在死前不太可能去全科医生诊所就诊。

方法

我们对大曼彻斯特12个卫生区35岁以下自杀者的两年样本进行了全科医疗接触情况的回顾性调查。在已知在死前三个月去看全科医生的61名年轻自杀者中,我们记录了:(a)自杀前三个月每周的就诊次数;(b)就诊率和就诊原因的性别差异;(c)自杀前最后一次全科医生就诊时记录的风险评估频率。

结果

死前看全科医生的次数显著增加。男性每月的增加更为明显,但女性在死前一周的增加更为显著。自杀前看全科医生的就诊率没有性别差异;男女最有可能因心理原因就诊。在最后一次全科医生就诊时均未发现显著的自杀风险。

结论

全科医生在预防男女青年自杀方面仍有潜在作用。年轻男性自杀率最近的上升似乎与死前看全科医生的就诊率较低无关。未来全科医生在这方面的培训应侧重于风险评估。

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