Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study.
Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study.
复制标题
DOI：
10.1176/ajp.153.8.1001
复制
发表时间：
1996-08
期刊：
影响因子：
--
通讯作者：
Y. Conwell;P. Duberstein;C. Cox;John H. Herrmann;N. Forbes;E. Caine
中科院分区：
文献类型：
--
作者：
Y. Conwell;P. Duberstein;C. Cox;John H. Herrmann;N. Forbes;E. Caine
目的精神疾病是自杀的潜在危险因素，其发生率随年龄而显著不同。本研究的目的是探讨自杀受害者的精神病诊断是否随年龄而变化。方法采用精神尸检法对141例21 ~ 92岁自杀未遂者进行DSM-III-R轴I诊断。多元逻辑回归分析用于确定年龄、性别或其相互作用是否可预测特定疾病的存在。结果90.1%的自杀者可诊断出一种或多种I轴疾病。物质使用障碍最常见，其次是情绪障碍和原发性精神病。死亡时年龄较小是药物滥用或依赖和原发性精神病的重要预测因素，而年龄较大则预测了主要的情绪障碍。物质使用和情绪障碍的共病是常见的。在有药物滥用或依赖的受害者中，死亡时年龄较大预示着重度抑郁症;在有情绪障碍的受害者中，死亡时年龄较小预示着共病药物滥用或依赖。结论：自杀者精神疾病的分布在不同的生命历程中是不同的。成瘾性和精神病的成瘾相关模式反映了其在一般人群中的患病率。相比之下，自杀者的年龄与情绪障碍之间的关系与一般人群明显不同。这些发现表明，在患有严重情感疾病的个体中，自杀的风险随着年龄的增长而增加。抑郁的老年男性是自杀预防策略的特定目标。
OBJECTIVE Psychiatric illness is a potent risk factor for suicide, rates of which differ markedly with age. The purpose of this study was to examine whether the psychiatric diagnoses of suicide victims vary predictably with age. METHOD DSM-III-R axis I diagnoses of 141 persons aged 21 to 92 years who had completed suicide were established by the psychological autopsy method. Multiple logistic regression analyses were used to determine whether age, gender, or their interaction predicted the presence of specific disorders. RESULTS One or more axis I conditions were diagnosable in 90.1% of the suicide victims. Substance use disorders were most frequent, followed by mood disorders and primary psychotic illness. Younger age at death was a significant predictor of substance abuse or dependence and primary psychoses, while older age predicted major mood disorders. Comorbidity of substance use and mood disorders was common. Among victims with substance abuse or dependence, older age at death predicted major depression; among victims with mood disorders, younger age at death predicted comorbid substance abuse or dependence. CONCLUSIONS The distribution of psychiatric illnesses in suicide victims differs across the life course. Age-related patterns of addictive and psychotic disorders echo their prevalence in the general population. In contrast, the relationship between age and mood disorders among suicide victims is distinctly different from that of the general population. These findings suggest that risk for suicide increases with age in individuals with major affective illness. Depressed elderly men are particular targets for suicide prevention strategies.