Lifetime suicide risk in major depression: sex and age determinants
Lifetime suicide risk in major depression: sex and age determinants
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DOI：
10.1016/s0165-0327(99)00004-x
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发表时间：
1999-10-01
影响因子：
6.6
通讯作者：
Eyeson-Annan, ML
中科院分区：
文献类型：
--
作者：
Blair-West, GW;Cantor, CH;Eyeson-Annan, ML
背景：最近的研究表明，DSM IV重度抑郁症患者的终生自杀风险在数学上不能接近15%的可接受数字。性别和年龄显著影响严重抑郁症和自杀风险的患病率，方法：使用数学算法对1994年美国全部人口进行性别和年龄分层计算。在设计中纳入了针对漏报的性别校正。结果：男性终生自杀风险为7%，女性终生自杀风险为1%。综合风险为3.4%。在25岁以下的青少年中，重度抑郁症自杀风险的男性与女性比例为10：1，成人为5.6：1。结论：重度抑郁症的自杀主要是男性的问题，尽管应该避免对女性患者的自满。与病例特有的因素相比，重度抑郁症的诊断对预测自杀风险的帮助有限。男性抑郁导致自杀的经历通常不会被患者或专业人士认定为合法的医疗投诉。增加男性获得帮助是当务之急。临床意义：有住院史的患者，特别是药物滥用的共病患者，以及男性患者，需要对自杀风险保持更高的警惕。这可能是因为对于男性来说，诊断和治疗严重抑郁症的ChE门槛需要降低。局限性：这项研究是基于一种数学算法，近似于一项确定社区抑郁症病例的终身纵向研究。因此，我们的发现依赖于所使用的统计数据的有效性。外推仅限于实际自杀率为17/10万或更低的人群，以及终生严重抑郁症患病率为17%或更高的人群。(C)1999 Elsevier Science B.V.保留所有权利。
Background: Recent work has demonstrated that the lifetime suicide risk for patients with DSM IV Major Depression cannot mathematically approximate the accepted figure of 15%. Gender and age significantly affect both the prevalence of major depression and suicide risk, Methods: Gender and age stratified calculations were made on the entire population of the USA in 1994 using a mathematical algorithm. Sex specific corrections for under-reporting were incorporated into the design. Results: The lifetime suicide risks for men and women were 7% and 1%, respectively. The combined risk was 3.4%. The male:female ratio for suicide risk in major depression was 10:1 for youths under 25, and 5.6:1 for adults. Conclusions: Suicide in major depression is predominantly a male problem, although complacency towards female sufferers is to be avoided. Diagnosis of major depression is of limited help in predicting suicide risk compared to case specific factors. The male experience of depression that leads to suicide is often not identified as a legitimate medical complaint by either sufferers or professionals. Increasing help-accessing by males is a priority. Clinical implications: Patients with a history of hospitalisation; comorbidity, especially for substance abuse; and who are male, require greater vigilance for suicide risk. It may be that for males che threshold for diagnosing and treating major depression needs to be lowered. Limitations: This research is based on a mathematical algorithm to approximate a life-long longitudinal study that identifies community cases of depression. Our findings therefore rely on the validity of the statistics used. Extrapolation is limited to populations with an actual suicide rate of 17/100,000 or less and a lifetime prevalence of major depression of 17% or more. (C) 1999 Elsevier Science B.V. All rights reserved.