The Collision of Mental Health, Substance Use Disorder, and Suicide
The Collision of Mental Health, Substance Use Disorder, and Suicide
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DOI：
10.1097/aog.0000000000004391
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发表时间：
2021-06-01
影响因子：
7.2
通讯作者：
Yonkers, Kimberly A.
中科院分区：
文献类型：
--
作者：
Forray, Ariadna;Yonkers, Kimberly A.
自杀是第十大死亡原因，在妇女中，近一半的自杀死亡发生在生育年龄。自杀与精神疾病有关，特别是情绪和焦虑症。童年的逆境，如身体，情感和性虐待，以及亲密伴侣暴力增加了自杀的风险。患有一种以上的精神疾病或共病物质使用障碍也会增加自杀的风险。物质使用障碍可能是那些有精神疾病和自杀想法的人自杀企图的触发因素。女性自杀未遂的次数是男性的三倍，尽管她们自杀的可能性较小。虽然自杀率在围产期有所下降，但孕妇更有可能使用暴力手段。在围产期完成自杀的妇女也更有可能是年轻，已婚，并经历抑郁发作。对许多妇女来说，她们与医疗系统的唯一接触可能是在生殖保健诊所。这意味着她们的妇产科医生有一个独特的机会来解决女性的心理健康问题并加强自杀预防。美国妇产科学院建议对围产期妇女进行抑郁症筛查。临床医生需要意识到，患有严重围产期抑郁症的妇女自杀的风险增加，有自杀想法的妇女需要仔细监测，评估和治疗。
Suicide is the 10th leading cause of death, and, in women, nearly half of all suicide deaths occur during their reproductive years. Suicide is associated with psychiatric illness, especially mood and anxiety disorders. Childhood adversities, such as physical, emotional, and sexual abuse, and intimate partner violence increase the risk of suicide. Having more than one psychiatric disorder or comorbid substance use disorder also increases the risk of suicide. Substance use disorders can be the triggering factor for a suicide attempt among those who have a psychiatric condition and suicidal thoughts. Women attempt suicide three times more often than men, although they are less likely to complete suicide. Although the rate of suicide decreases in the perinatal period, pregnant women are more likely to use violent means. Women who complete suicide in the perinatal period are also more likely to be younger, married, and experiencing a depressive episode. For many women, the only encounter with the medical system they have might be in reproductive health care clinics. This means that their obstetrician-gynecologist has a unique opportunity to address women's mental health and enhance suicide prevention. The American College of Obstetricians and Gynecologists recommends screening for depression among perinatal women. Clinicians need to be aware that women with severe perinatal depression are at increased risk of suicide and that women with suicidal thoughts need careful monitoring, evaluation, and treatment.