SUICIDE IN THE HOME IN RELATION TO GUN OWNERSHIP
SUICIDE IN THE HOME IN RELATION TO GUN OWNERSHIP
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DOI：
10.1056/nejm199208133270705
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发表时间：
1992-08-13
影响因子：
158.5
通讯作者：
HACKMAN, BB
中科院分区：
文献类型：
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作者：
KELLERMANN, AL;RIVARA, FP;HACKMAN, BB
背景资料。有人建议，限制枪支的使用可以防止许多人自杀，但这种观点是有争议的。为了评估枪支供应与自杀之间联系的强度，我们研究了田纳西州谢尔比县和华盛顿州金县在32个月内发生在受害者家中的所有自杀事件。对于每个自杀受害者(案件对象)，我们从警方或法医那里获得数据，并约谈代理人。他们的答案与来自同一社区的对照组的答案进行了比较，并根据性别、种族和年龄范围与受害者进行了匹配。用配对方法计算粗略和调整后的优势比。在研究期间，这两个县发生了803起自杀事件，其中565起(70%)发生在受害者的家中。其中58%(326人)的自杀是用枪支实施的。在因各种原因排除11个案例对象后，我们能够采访80%(442)的案例对象的代理人。99%的受试者被确定为匹配的对照组，产生了438对匹配的配对。单变量分析显示，病例受试者比对照组更有可能独居、服用处方精神药物、被捕、滥用药物或酒精，或者没有高中毕业。在我们通过条件Logistic回归对这些特征进行控制后，发现家中有一支或多支枪与自杀风险的增加有关(调整后的优势比为4.8；95%可信区间为2.7至8.5)。随手可得的枪支与家庭自杀风险的增加有关。枪支拥有者应该权衡一下，他们把枪放在家里的理由，还是有一天枪可能被用来自杀的可能性。
Background. It has been suggested that limiting access to firearms could prevent many suicides, but this belief is controversial. To assess the strength of the association between the availability of firearms and suicide, we studied all suicides that took place in the homes of victims in Shelby County, Tennessee, and King County, Washington, over a 32-month period.Methods. For each suicide victim (case subject), we obtained data from police or the medical examiner and interviewed a proxy. Their answers were compared with those of control subjects from the same neighborhood, matched with the victim according to sex, race, and age range. Crude and adjusted odds ratios were calculated with matched-pairs methods.Results. During the study period, 803 suicides occurred in the two counties, 565 of which (70 percent) took place in the home of the victim. Fifty-eight percent (326) of these suicides were committed with a firearm. After excluding 11 case subjects for various reasons, we were able to interview 80 percent (442) of the proxies for the case subjects. Matching controls were identified for 99 percent of these subjects, producing 438 matched pairs. Univariate analyses revealed that the case subjects were more likely than the controls to have lived alone, taken prescribed psychotropic medication, been arrested, abused drugs or alcohol, or not graduated from high school. After we controlled for these characteristics through conditional logistic regression, the presence of one or more guns in the home was found to be associated with an increased risk of suicide (adjusted odds ratio, 4.8; 95 percent confidence interval, 2.7 to 8.5).Conclusions. Ready availability of firearms is associated with an increased risk of suicide in the home. Owners of firearms should weigh their reasons for keeping a gun in the home against the possibility that it might someday be used in a suicide.