Deliberate self-harm in people aged 60 years and over: characteristics and outcome of a 20-year cohort
Deliberate self-harm in people aged 60 years and over: characteristics and outcome of a 20-year cohort
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DOI：
10.1002/gps.1526
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发表时间：
2006-06-01
影响因子：
4
通讯作者：
Harriss, Louise
中科院分区：
文献类型：
--
作者：
Hawton, Keith;Harriss, Louise
背景资料很少是关于老年人故意自我伤害（DSH）patients and their outcome.Methods本研究是一项前瞻性调查和随访的730例连续患者（459名女性和271名男性）年龄60岁及以上谁提出了一个综合医院以下DSH超过20年的时间，1978-1997年。结果已检查DSH的重复方面，并确定通过官方death registers.Results DSH在2000年年底涉及的88.6%的情况下，49.3%的过量，包括扑热息痛（醋氨酚），24.0%的轻微镇静剂，和15.9%的抗抑郁药的自我中毒。近四分之三的事件涉及强烈的自杀意图。DSH前常见的问题是身体疾病（46.1%），社会孤立（33.5%），与家人（29.4%）或伴侣（25.9%）的关系问题，以及丧亲或失去亲人（16.7%）。15.3%的病例重复DSH，8.2%发生在DSH后的第一年。到2000年底，661名被追踪的患者中有432人（65.4%）死亡。有30起自杀和公开判决，分别是一般人口死亡率的49倍和33倍。在初次就诊前的DSH是自杀的主要危险因素，一些证据表明高自杀意图是另一个因素。也有过多的死亡，由于几种类型的身体disorder.Conclusions老年人的DSH是密切相关的自杀，无论是在自杀意图和最终自杀的风险，特别是当DSH是重复的。老年DSH患者所经历的一系列问题需要广泛和多学科的临床干预。版权所有（c）2006约翰威利父子有限公司。
Background Little information is available about older deliberate self-harm (DSH) patients and their outcome.Methods This study is a prospective investigation and follow-up of 730 consecutive patients (459 females and 271 males) aged 60 years and over who presented to a general hospital following DSH over a 20-year period, 1978-1997. Outcome has been examined in terms of repetition of DSH, and deaths by the end of 2000 identified through official death registers.Results DSH involved self-poisoning in 88.6% of cases, 49.3% of the overdoses including paracetamol (acetaminophen), 24.0% minor tranquillizers, and 15.9% antidepressants. Nearly three-quarters of episodes involved high suicidal intent. Common problems preceding DSH were physical illness (46.1%), social isolation (33.5%), relationship problems with family (29.4%) or partner (25.9%), and bereavement or loss (16.7%). Repetition of DSH occurred in 15.3% of cases, 8.2% in the first year following DSH. By the end of 2000, 432/661 (65.4%) of traced patients had died. There were 30 suicides and open verdicts, which were 49 times and 33 times more frequent respectively than expected from general population death rates. Prior DSH before initial presentation was the main risk factor for suicide, with some evidence of high suicide intent being another factor. There were also excess deaths due to several types of physical disorder.Conclusions DSH in older people is closely related to suicide, both in terms of suicidal intent and risk of eventual suicide, especially when DSH is repeated. The range of problems experienced by older DSH patients requires extensive and multidisciplinary clinical interventions. Copyright (c) 2006 John Wiley & Sons, Ltd.