The association between self-reported mental health, medication record and suicide risk: A population wide study.
The association between self-reported mental health, medication record and suicide risk: A population wide study.
复制标题
自我报告的心理健康、用药记录和自杀风险之间的关系：一项广泛的人口研究。
DOI：
10.1016/j.ssmph.2021.100749
复制
发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Maguire A
中科院分区：
文献类型：
--
作者：
Onyeka IN;O'Reilly D;Maguire A
自杀死亡率和精神疾病在全球范围内都在增加。精神疾病的健康状况可以用多种方式来衡量。目前还不清楚哪种措施与自杀风险最相关。本研究探讨了自测心理健康与服药记录与自杀死亡之间的关系。到2015年底，北爱尔兰2011年18-74岁成年人(n=1,098,967)的人口普查记录与处方药物和死亡登记的中央数据库建立了联系。精神健康状况是通过人口普查中的单一项目自我报告问题和接受精神药物治疗来确定的。Logistic回归模型检验了精神疾病指标和自杀死亡可能性之间的关系。在1098,967名队列成员中，有857人在研究期间自杀身亡。其中略多于一半的死亡(n=429，50.1%)发生在没有精神疾病症状的个人身上。队列成员中既有精神疾病史又有精神药物史者的自杀危险性最高(OR=6.13，95%CI：4.94~7.61)，其次是仅有精神药物史者(OR=4.00，95%CI：3.28~4.88)和仅有精神药物史者(OR=2.88，95%CI：2.16~3.84)。报告精神健康状况不佳并有精神药物使用史的人自杀死亡的风险很高。然而，这两个指标都不是特别敏感，因为这两个指标都未能发出随后自杀人数超过一半的信号。一些报告精神健康状况不佳但没有接受精神药物治疗的人自杀的风险增加，这表明可能没有得到满足的治疗需求。这两项指标相结合，可以更准确地确定哪些人面临针对性干预的风险最大。精神疾病与自杀风险的增加有关，但衡量人群的心理健康是困难的。自杀风险与精神疾病的主观和客观指标都没有被审查。大多数自杀身亡的人都没有精神疾病的迹象。自称精神健康状况不佳且有精神药物服药记录的人自杀死亡风险最高。在报告精神健康状况不佳但没有服用药物的个人中，自杀风险增加可能表明需求未得到满足。
Suicide mortality and mental ill health are increasing globally. Mental ill health can be measured in multiple ways. It is unclear which measure is most associated with suicide risk. This study explored the association between self-rated mental health and medication record and death by suicide. The 2011 Northern Ireland Census records of adults aged 18-74 years (n=1,098,967) were linked to a centralised database of dispensed prescription medication and death registrations until the end of 2015. Mental health status was ascertained through both a single-item self-reported question in the Census and receipt of psychotropic medication. Logistic regression models examined the association between indicators of mental ill health and likelihood of suicide mortality. Of the 1,098,967 cohort members, 857 died by suicide during the study period. Just over half of these deaths (n=429, 50.1%) occurred in individuals with neither indicator of mental ill health. Cohort members with both self-reported mental ill health and receipt of psychotropic medication had the highest risk of suicide (OR=6.13, 95%CI: 4.94–7.61), followed by those with psychotropic medication record only (OR=4.00, 95%CI: 3.28–4.88) and self-report only (OR=2.88, 95%CI: 2.16–3.84). Individuals who report mental ill health and have a history of psychotropic medication use are at a high risk of suicide mortality. However, neither measure is particularly sensitive, as both failed to signal over half of subsequent suicides. Some individuals who report poor mental health but are not in receipt of psychotropic medication are at increased risk of suicide, indicating possible unmet treatment need. The combination of the two indicators offers more precision for identifying those most at risk for targeted interventions. Mental ill health is associated with an increased risk of suicide, but measuring population mental health is difficult. The suicide risk associated with both subjective and objective indicators of mental ill health have not been examined. Most individuals who die by suicide have no indicator of mental ill health. Having both self-reported poor mental health and psychotropic medication record carried the highest risk of suicide death. Increased risk of suicide in individuals who report poor mental health but are not on medication may indicate unmet need.
登录
查看更多内容
影响因子：
2.8
作者：
Ahmad F;Jhajj AK;Stewart DE;Burghardt M;Bierman AS
通讯作者：
Bierman AS
影响因子：
6.7
作者：
Henriksson, S;Boëthius, G;Isacsson, G
通讯作者：
Isacsson, G
影响因子：
6.8
作者：
Batty GD;Kivimäki M;Bell S;Gale CR;Shipley M;Whitley E;Gunnell D
通讯作者：
Gunnell D
影响因子：
7.7
作者：
Connolly, Sheelah;O'Reilly, Dermot;Rosato, Michael
通讯作者：
Rosato, Michael
影响因子：
7
作者：
Huebner-Liebermann, Bettina;Neuner, Tanja;Spiessl, Hermann
通讯作者：
Spiessl, Hermann