Proulx F, Lesage A D, Grunberg F
Hôpital Charles LeMoyne, Department of Psychiatry, University of Sherbrooke, Quebec, Canada.
Br J Psychiatry. 1997 Sep;171:247-50. doi: 10.1192/bjp.171.3.247.
The study aimed to define the characteristics and assess the clinical predictability and possible prevention of psychiatric in-patient suicides.
The coroner's files on all suicides in the Greater Montreal Region from 1 April 1986 to 31 March 1991 were examined. The medical records of each case of suspected in-patient suicide were then reviewed and rated for predictability and preventive measures taken.
A total of 3079 suicides were recorded over this five-year period (mean annual rate of 16.4 per 100,000 inhabitants). Of these, 104 (3.4%) involved hospital in-patients. Nearly half (48%) of these in-patient suicides occurred outside the hospital setting. The methods most frequently employed were hanging (36%) and jumping from high places (24%). Patients suffering from an affective disorder (45%) or schizophrenia (35%) comprised the majority of the sample. Suicides were significantly more predictable in general hospital psychiatric wards. Suicide prevention measures did not differ significantly across settings.
The majority of in-patient suicides were not highly predictable. For highly predictable suicides, the results underline the importance of actively treating and protecting these patients.
本研究旨在明确精神病住院患者自杀的特征，评估其临床可预测性及可能的预防措施。
查阅了1986年4月1日至1991年3月31日大蒙特利尔地区所有自杀事件的验尸官档案。随后对每例疑似住院患者自杀病例的医疗记录进行审查，并对可预测性和所采取的预防措施进行评级。
在这五年期间共记录了3079起自杀事件（平均年发生率为每10万居民16.4例）。其中，104例（3.4%）涉及住院患者。这些住院患者自杀事件中近一半（48%）发生在医院外。最常采用的方法是上吊（36%）和高处跳下（24%）。样本中的大多数患者患有情感障碍（45%）或精神分裂症（35%）。综合医院精神科病房的自杀事件总体上更具可预测性。不同环境下的自杀预防措施差异不显著。
大多数住院患者自杀事件并非高度可预测。对于高度可预测的自杀事件，研究结果强调了积极治疗和保护这些患者的重要性。
