Suicide in children and young people in England: a consecutive case series
Suicide in children and young people in England: a consecutive case series
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DOI：
10.1016/s2215-0366(16)30094-3
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发表时间：
2016-08-01
影响因子：
64.3
通讯作者：
Appleby, Louis
中科院分区：
文献类型：
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作者：
Rodway, Cathryn;Tham, Su-Gwan;Appleby, Louis
儿童和青少年的心理健康以及这一群体中自杀行为的可能上升令人担忧。我们已经做了一个全面的国家多机构研究自杀在20岁以下的英格兰。我们的目的是确定自杀前有多频繁的儿童特异性和年轻人特异性自杀风险因素，以及所有年龄段的因素，并确定与卫生保健和社会保健服务和司法机构的联系。2014年和2015年4月30日。我们从国家统计局（ONS）获得了一般人口死亡率数据。我们收集了被认为与自杀有关的前因信息（例如，虐待，欺凌，丧亲之痛，学术压力，自我伤害，和身体健康）从一系列的调查和询问，包括验尸官研讯听证会，儿童死亡调查，刑事司法系统报告，和国家卫生服务，包括在死亡前12个月内与精神卫生服务机构接触的人的数据。结果在研究期间，我们收到了145起20岁以下自杀事件的通知，其中130例（90%）能获得有关前因的报告数据。在青少年后期，自杀人数急剧上升，18-19岁的人中有79人死于自杀，而18岁以下的人中有66人。102例（70%）死亡为男性。92人（63%）死于绞刑。在我们报告数据的个人中报告了各种前因，包括学术（尤其是考试）压力（35 [27%]人），欺凌（28人[22%]）、丧亲之痛（36 [28%]），家人或朋友自杀（17 [13%]），身体健康状况（47 [36%]），家庭问题（44 [34%]），社会孤立或退缩（33 [25%]），虐待或忽视儿童（20 [15%]），过度饮酒（34 [26%]）和非法药物使用（38 [29%]）。在30例（23%）病例中记录了与自杀相关的互联网使用。在死亡前一周，13人（10%）曾自残，35人（27%）曾表达过自杀念头。56（43%）个人没有已知的接触与医疗保健和社会保健服务或司法agencies.Interpretation自我伤害和心理健康的改善服务是至关重要的自杀预防，但广泛的先例强调学校，初级保健，社会服务和青年司法系统的作用。
Background There is concern about the mental health of children and young people and a possible rise in suicidal behaviour in this group. We have done a comprehensive national multi-agency study of suicide in under 20s in England. We aimed to establish how frequently suicide is preceded by child-specific and young person-specific suicide risk factors, as well as all-age factors, and to identify contact with health-care and social-care services and justice agencies.Methods This study is a descriptive examination of suicide in a national consecutive sample of children and young people younger than 20 years who died by suicide in England between Jan 1, 2014, and April 30, 2015. We obtained general population mortality data from the Office for National Statistics (ONS). We collected information about antecedents considered to be relevant to suicide (eg, abuse, bullying, bereavement, academic pressures, self-harm, and physical health) from a range of investigations and inquiries, including coroner inquest hearings, child death investigations, criminal justice system reports, and the National Health Service, including data on people in contact with mental health services in the 12 months before their death.Findings 145 suicides in people younger than 20 years were notified to us during the study period, of which we were able to obtain report data about antecedents for 130 (90%). The number of suicides rose sharply during the late teens with 79 deaths by suicide in people aged 18-19 years compared with 66 in people younger than 18 years. 102 (70%) deaths were in males. 92 (63%) deaths were by hanging. Various antecedents were reported among the individuals for whom we had report data, including academic (especially exam) pressures (35 [27%] individuals), bullying (28 [22%]), bereavement (36 [28%]), suicide in family or friends (17 [13%]), physical health conditions (47 [36%]), family problems (44 [34%]), social isolation or withdrawal (33 [25%]), child abuse or neglect (20 [15%]), excessive drinking (34 [26%]), and illicit drug use (38 [29%]). Suicide-related internet use was recorded in 30 (23%) cases. In the week before death 13 (10%) individuals had self-harmed and 35 (27%) had expressed suicidal ideas. 56 (43%) individuals had no known contact with health-care and social-care services or justice agencies.Interpretation Improved services for self-harm and mental health are crucial to suicide prevention, but the wide range of antecedents emphasises the roles of schools, primary care, social services, and the youth justice system.