Krug E G, Kresnow M, Peddicord J P, Dahlberg L L, Powell K E, Crosby A E, Annest J L
Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
N Engl J Med. 1998 Feb 5;338(6):373-8. doi: 10.1056/NEJM199802053380607.
Among the victims of floods, earthquakes, and hurricanes, there is an increased prevalence of post-traumatic stress disorder and depression, which are risk factors for suicidal thinking. We conducted this study to determine whether natural disasters affect suicide rates.
From a list of all the events declared by the U.S. government to be federal disasters between 1982 and 1989, we selected the 377 counties that had each been affected by a single natural disaster during that period. We collected data on suicides during the 36 months before and the 48 months after the disaster and aligned the data around the month of the disaster. Pooled rates were calculated according to the type of disaster. Comparisons were made between the suicide rates before and those after disasters in the affected counties and in the entire United States.
Suicide rates increased in the four years after floods by 13.8 percent, from 12.1 to 13.8 per 100,000 (P<0.001), in the two years after hurricanes by 31.0 percent, from 12.0 to 15.7 per 100,000 (P<0.001), and in the first year after earthquakes by 62.9 percent, from 19.2 to 31.3 per 100,000 (P<0.001). The four-year increase of 19.7 percent after earthquakes was not statistically significant. Rates computed in a similar manner for the entire United States were stable. The increases in suicide rates were found for both sexes and for all age groups. The suicide rates did not change significantly after tornadoes or severe storms.
Our study shows that suicide rates increase after severe earthquakes, floods, and hurricanes and confirms the need for mental health support after severe disasters.
在洪水、地震和飓风的受害者中，创伤后应激障碍和抑郁症的患病率有所上升，而这些都是自杀念头的风险因素。我们开展这项研究以确定自然灾害是否会影响自杀率。
从美国政府宣布为1982年至1989年期间联邦灾难的所有事件列表中，我们挑选出在此期间每个都只受到一次自然灾害影响的377个县。我们收集了灾难发生前36个月和灾难发生后48个月的自杀数据，并将数据围绕灾难发生月份进行整理。根据灾难类型计算合并率。对受灾县和整个美国灾难前后的自杀率进行了比较。
洪水过后四年自杀率上升了13.8%，从每10万人12.1例增至13.8例（P<0.001）；飓风过后两年自杀率上升了31.0%，从每10万人12.0例增至15.7例（P<0.001）；地震后第一年自杀率上升了62.9%，从每10万人19.2例增至31.3例（P<0.001）。地震后四年19.7%的上升在统计学上不显著。以类似方式计算的整个美国的自杀率是稳定的。男女及所有年龄组的自杀率均有上升。龙卷风或严重风暴过后自杀率没有显著变化。
我们的研究表明，严重地震、洪水和飓风过后自杀率会上升，并证实了严重灾难后提供心理健康支持的必要性。
