Risk factors for suicide in Hungary: a case-control study
Risk factors for suicide in Hungary: a case-control study
复制标题
DOI：
10.1186/1471-244x-9-45
复制
发表时间：
2009-07-28
期刊：
影响因子：
4.4
通讯作者：
Appleby, Louis
中科院分区：
文献类型：
--
作者：
Almasi, Kitty;Nora Belso;Appleby, Louis
背景：匈牙利以前是世界上自杀率最高的国家之一，但自1990年以来经历了重大的社会和经济变化。我们的目标是调查匈牙利自杀的前科。我们假设匈牙利的自杀将与西方研究中确定的自杀危险因素以及与社会和经济重组相关的经历有关。对194例自杀病例(布达佩斯和佩斯特县2002-2004年自杀死亡)和194例对照进行了详细的临床医生访谈。结果：许多与其他环境中自杀有关的人口统计学和临床危险因素也与匈牙利的自杀有关；例如，未婚或没有当前关系，缺乏其他社会关系，低教育程度，自我伤害史，目前诊断的情感障碍(包括双相情感障碍)或人格障碍，以及经历最近的重大不良生活事件。反映经济结构调整以来经历的一些变量也与自杀有关；例如，失业、对工作前景的担忧、生活水平的变化、信奉宗教。在死亡时有抑郁症证据的病例中，只有20%的人接受了抗抑郁药物治疗。结论：匈牙利的自杀率正在下降。我们的研究确定了一些与个体水平的人口学和临床特征有关的危险因素，可能还有最近的社会变化。改善对精神障碍和自我伤害的管理可能会进一步降低自杀率。
Background: Hungary previously had one of the highest suicide rates in the world, but experienced major social and economic changes from 1990 onwards. We aimed to investigate the antecedents of suicide in Hungary. We hypothesised that suicide in Hungary would be associated with both risk factors for suicide as identified in Western studies, and experiences related to social and economic restructuring.Methods: We carried out a controlled psychological autopsy study. Informants for 194 cases (suicide deaths in Budapest and Pest County 2002-2004) and 194 controls were interviewed by clinicians using a detailed schedule.Results: Many of the demographic and clinical risk factors associated with suicide in other settings were also associated with suicide in Hungary; for example, being unmarried or having no current relationship, lack of other social contacts, low educational attainment, history of self-harm, current diagnosis of affective disorder (including bipolar disorder) or personality disorder, and experiencing a recent major adverse life event. A number of variables reflecting experiences since economic restructuring were also associated with suicide; for example, unemployment, concern over work propects, changes in living standards, practising religion. Just 20% of cases with evidence of depression at the time of death had received antidepressants.Conclusion: Suicide rates in Hungary are falling. Our study identified a number of risk factors related to individual-level demographic and clinical characteristics, and possibly recent societal change. Improved management of psychiatric disorder and self-harm may result in further reductions in suicide rates.