RISK OF SUICIDE BY PSYCHIATRIC-DIAGNOSIS IN STOCKHOLM COUNTY - A LONGITUDINAL-STUDY OF 80,970 PSYCHIATRIC-INPATIENTS
RISK OF SUICIDE BY PSYCHIATRIC-DIAGNOSIS IN STOCKHOLM COUNTY - A LONGITUDINAL-STUDY OF 80,970 PSYCHIATRIC-INPATIENTS
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DOI：
10.1007/bf02195984
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发表时间：
1992-05-01
影响因子：
4.7
通讯作者：
RICE, JP
中科院分区：
文献类型：
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作者：
ALLGULANDER, C;ALLEBECK, P;RICE, JP
在斯德哥尔摩县（人口160万）的80,970名住院患者中，估计了与不同精神病诊断相关的自杀风险。1973年至1986年期间，所有出院的患者至少有一种精神病诊断，并在1987年之前与死因登记联系起来。在15年的随访中，有1，115人明确自杀，467人未确定自杀。当12个诊断类别进入比例风险模型时，控制性别和年龄后，明确自杀的相对风险（RR）最高的是情感障碍（RR 2.82），其次是未指明的精神病（RR 2.69），偏执型精神病（RR 2.60）。处方药成瘾（RR 2.38）、神经症和反应性精神病（RR 1.96）。精神分裂症（RR 1.64）。酗酒、人格障碍、器质性精神病和街头吸毒成瘾并没有显著增加自杀的风险。男性自杀的风险增加了1.56，而年轻人的风险略高。有一个以上的诊断增加了1.42的相对风险。当分析中包括未确定的自杀事件时，酗酒和街头吸毒导致自杀风险显著增加，可能是由于核实此类案件的难度更大。我们的结论是，几种精神疾病是导电自杀。但风险并不因诊断类型而有太大变化。需要进一步研究混杂因素，如住院治疗的原因，以及躯体和精神共病的影响。
The risk of suicide associated with different psychiatric diagnoses was estimated in 80,970 inpatients in Stockholm County (population 1.6 million), All patients discharged with at least one psychiatric diagnosis between 1973 and 1986 were followed by linkage with the cause-of-death registry through 1987. There were 1,115 definite suicides and 467 undetermined suicides among these during the 15-year follow-up. When 12 diagnostic categories were entered in a proportional hazards model, the highest relative risk (RR) of definite suicide, controlling for sex and age, was noted for affective disorders (RR 2.82), followed by unspecified psychoses (RR 2.69), paranoid psychoses (RR 2.60). addiction to prescription drugs (RR 2.38), neuroses and reactive psychoses (RR 1.96). and schizophrenia (RR 1.64). Alcoholism, personality disorders, organic psychoses, and street drug addiction did not have significantly increased risks of suicide. Male sex increased the risk for definite suicide by 1.56, while the risk was somewhat higher among the young. Having more than one diagnosis increased the relative risk by 1.42. When undetermined suicides were included in the analysis, to alcoholism and street drug abuse were attributed significantly increased risks of suicide, probably owing to the greater difficulty of verifying such cases. We conclude that several psychiatric disorders were conductive to suicide. but that the risk did not vary much with the type of diagnosis. Further studies of confounders are needed, such as the reasons for being admitted to inpatient care, and the impact of somatic and psychiatric comorbidity.