Dudley M, Kelk N, Florio T, Waters B, Howard J, Taylor D
Department of Child and Adolescent Psychiatry, University of New South Wales, Australia.
Aust N Z J Psychiatry. 1998 Apr;32(2):242-51. doi: 10.3109/00048679809062735.
The aim of this study is to compare the frequency of certain putative risk factors for youth suicide in New South Wales (especially use of alcohol, social class, unemployment, and internal migration) in metropolitan and rural settings.
A review of 137 files for 10-19-year-old subjects judged by the Coroner to have committed suicide in 1988-1990 was carried out.
One hundred and fifteen males and 21 females were identified (one subjects sex was unavailable). The male-female ratio was higher in rural (13.0) areas than non-rural (4.9 chi 2 = 12.14, p < 0.01). Of 27 subjects migrating within Australia, most migrated in a rural direction, and most to rural shires. Unemployment was somewhat more common among rural (38.5%) than non-rural (28.9%) subjects (chi 2 = 0.75, p = 0.39). Eleven of 50 non-rural parents of the deceased, but none of the 11 rural parents, were ranked as being in social classes 2 or 3. Alcohol consumption appeared more common in rural shires (44%) than metropolitan areas (32.9%), but this was not statistically significant. Medical services were less utilised prior to death in rural (15%) than non-rural (25%) areas (chi 2 = 1.69, p = 0.19), and a psychiatric diagnosis was recorded more commonly in non-rural areas.
Incomplete coronial file data and relatively small numbers limit this study's conclusions. Male suicides, principally by firearms, predominated in rural areas. Youth firearm access remains highly relevant to rural communities. Possible trends among rural subjects toward rural migration, higher unemployment, lower social class and lower medical attendance may point to resource deprivation among this group; these matters require further investigation.
本研究旨在比较新南威尔士州大都市和农村地区青少年自杀某些假定风险因素（尤其是酒精使用、社会阶层、失业和内部迁移）的出现频率。
对1988 - 1990年死因裁判官判定自杀的10 - 19岁受试者的137份档案进行了回顾。
确定了115名男性和21名女性（1名受试者性别信息缺失）。农村地区男女比例（13.0）高于非农村地区（4.9，卡方 = 12.14，p < 0.01）。在27名在澳大利亚境内迁移的受试者中，大多数向农村地区迁移，且大多迁至农村郡。农村地区受试者（38.5%）的失业率略高于非农村地区受试者（28.9%）（卡方 = 0.75，p = 0.39）。在50名非农村地区死者的父母中，有11人被列为社会阶层2或3，但11名农村地区死者的父母中无人在此阶层。农村郡（44%）的酒精消费似乎比大都市地区（32.9%）更为普遍，但无统计学意义。农村地区（15%）在死亡前对医疗服务的利用率低于非农村地区（25%）（卡方 = 1.69，p = 0.19），非农村地区更常记录有精神科诊断。
死因裁判官档案数据不完整且数量相对较少限制了本研究的结论。农村地区男性自杀为主，主要方式为枪支。青少年获取枪支的情况与农村社区高度相关。农村受试者中可能存在的向农村迁移、失业率较高、社会阶层较低和就医率较低的趋势可能表明该群体资源匮乏；这些问题需要进一步调查。
