Emergency department contact prior to suicide in mental health patients
Emergency department contact prior to suicide in mental health patients
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DOI：
10.1136/emj.2009.081869
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发表时间：
2011-06-01
影响因子：
3.1
通讯作者：
Kapur, N.
中科院分区：
文献类型：
--
作者：
Da Cruz, D.;Pearson, A.;Kapur, N.
目的描述精神健康患者自杀前一年急诊就诊情况。要检查那些谁出席（特别是那些谁经常出席）前suicid.Design Case审查艾德记录的286个人谁死在12个月内的心理健康接触在英格兰西北部（2003-2005）。记录进行了检查，以建立出勤的数量，原因的最后，非致命的出勤，提供治疗和outcome.Results一百二十四（43%）个人参加了艾德至少一次在一年前，他们的死亡，其中，35（28%）参加了艾德在三个以上的场合。这些经常参加的人在最后一次非致命性的参加后死于自杀的时间比其他参加者要早。酒精滥用的临床史也与早期死亡以下艾德attendance.Conclusions超过40%的我们的临床样本出席了艾德在死亡前一年，有些人出席特别频繁。因此，ED可能是预防精神健康患者自杀的一个重要的附加设置。自杀前的大多数就诊都是为了自残或寻求精神科帮助。临床医生应警惕与此类表现相关的风险，以及频繁就诊与自杀之间的可能关联。
Objectives To describe attendance at emergency departments (EDs) in the year prior to suicide for a sample of mental health patients. To examine the characteristics of those who attended (particularly those who attended frequently) prior to suicide.Design Case review of ED records for 286 individuals who died within 12 months of mental health contact in North West England (2003-2005).Method Cases identified through the National Confidential Inquiry into Suicide were checked against regional EDs to establish attendance in the year prior to death. Records were examined to establish the number of attendances, reason for the final, non-fatal attendance, treatment offered and outcome.Results One hundred and twenty-four (43%) individuals had attended the ED at least once in the year prior to their death, and of these, 35 (28%) had attended the ED on more than three occasions. These frequent attenders died by suicide significantly sooner after their final, non-fatal attendance than other attenders. A clinical history of alcohol misuse was also associated with early death following ED attendance.Conclusions Over 40% of our clinical sample attended an ED in the year prior to death, and some individuals attended particularly frequently. EDs may therefore represent an important additional setting for suicide prevention in mental health patients. The majority of attendances prior to suicide were for self-harm or to request psychiatric help. Clinicians should be alert to the risk associated with such presentations and to the possible association between frequent attendance and suicide.