Psychiatric diagnoses in 3275 suicides: a meta-analysis
Psychiatric diagnoses in 3275 suicides: a meta-analysis
复制标题
DOI：
10.1186/1471-244x-4-37
复制
发表时间：
2004-01-01
期刊：
影响因子：
4.4
通讯作者：
Turecki, Gustavo
中科院分区：
文献类型：
--
作者：
Arsenault-Lapierre, Genevieve;Kim, Caroline;Turecki, Gustavo
背景：众所周知，大多数自杀案件符合精神障碍的标准。然而，在不同的研究中，特定疾病的发病率差异很大，而且关于性别和地理差异的信息知之甚少。本研究提供了自杀未遂者的总体和特定精神障碍的总体比率，并提供了支持其相对比例的性别和地理差异的证据。方法：我们对自杀未遂者的心理解剖研究进行了回顾。通过MEDLINE数据库检索和扫描相关出版物的参考文献列表来确定研究。共定义了23个变量，其中16个用于评估精神疾病。估计这16个结果变量的Mantel-Haenszel加权优势比。结果：纳入了27项研究，包括3275例自杀，其中87.3% （SD 10.0%）在死亡前被诊断为精神障碍。性别差异很大。诊断出与药物有关的问题（OR = 3.58; 95% CI: 2.78-4.61）、人格障碍（OR = 2.01; 95% CI: 1.38-2.95）和儿童障碍（OR = 4.95; 95% CI: 2.69-9.31）在男性自杀中更为常见，而情感障碍（OR = 0.66; 95% CI: 0.53-0.83），包括抑郁症（OR = 0.53; 95% CI: 0.42-0.68）在男性中较不常见。地域差异也可能出现在自杀中精神病诊断的相对比例上。结论：尽管精神病理明显介导自杀风险，但在自杀完成者中发现的特定精神障碍的相对比例似乎存在性别和地域差异。
Background: It is well known that most suicide cases meet criteria for a psychiatric disorder. However, rates of specific disorders vary considerably between studies and little information is known about gender and geographic differences. This study provides overall rates of total and specific psychiatric disorders in suicide completers and presents evidence supporting gender and geographic differences in their relative proportion.Methods: We carried out a review of studies in which psychological autopsy studies of suicide completers were performed. Studies were identified by means of MEDLINE database searches and by scanning the reference list of relevant publications. Twenty-three variables were defined, 16 of which evaluating psychiatric disorders. Mantel-Haenszel Weighted Odds Ratios were estimated for these 16 outcome variables.Results: Twenty-seven studies comprising 3275 suicides were included, of which, 87.3% (SD 10.0%) had been diagnosed with a mental disorder prior to their death. There were major gender differences. Diagnoses of substance-related problems (OR = 3.58; 95% CI: 2.78-4.61), personality disorders (OR = 2.01; 95% CI: 1.38-2.95) and childhood disorders (OR = 4.95; 95% CI: 2.69-9.31) were more common among male suicides, whereas affective disorders (OR = 0.66; 95% CI: 0.53-0.83), including depressive disorders (OR = 0.53; 95% CI: 0.42-0.68) were less common among males. Geographical differences are also likely to be present in the relative proportion of psychiatric diagnoses among suicides.Conclusions: Although psychopathology clearly mediates suicide risk, gender and geographical differences seem to exist in the relative proportion of the specific psychiatric disorders found among suicide completers.