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精神疾患とデンマークにおける自殺のリスク要因
P B Mortensen1, E Agerbo, T Erikson
1Department of Psychiatric Demography, Institute of Basic Psychiatric Research, Psychiatric Hospital in Aarhus, University Hospital in Aarhus, Denmark. pbm@psykiatri.aaa.dk
Lancet (London, England)
|January 1, 2000
まとめ
病院に入院を必要とする精神疾患は,自殺のリスク要因の中で最も強いものです. これらの患者のための標的型予防と,一般的なメンタルヘルスケアの改善は,自殺率を減らすことができます.
科学分野:
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
- 精神科医は精神病を患っている.
背景:
- 自殺は,複数の特定された危険因子を持つ重要な公衆衛生上の問題です.
- 以前の研究では,自殺の予測因子として社会経済的な要因と精神疾患の歴史を調査しました.
- 相対的および集団に起因するリスクを理解することは,効果的な予防戦略にとって極めて重要です.
研究 の 目的:
- 自殺の相対的なリスクと集団によるリスクを評価する.
- 社会経済的要因と,自殺リスクと,以前に入院した精神疾患との関連を調査する.
- ターゲットを絞った自殺予防戦略の策定を図る.
主な方法:
- デンマークの登録データを用いて,集団ベースのネスド症例対照研究が行われました.
- 1980年から1994年にかけてのデンマークの人口 (16歳から78歳) の5%のランダムサンプルを分析した.
- 統計分析には条件付きロジスティック回帰が用いられました.
主要な成果:
- 病院入院を必要とする精神疾患は,自殺の最も強い予測因子であり,入院中および退院後の1年間でリスクが著しく上昇しました.
- 失業や独身といった社会経済的要因は,自殺リスクの上昇と関連しているが,精神疾患歴を考慮した結果,その影響は減少した.
- 集団によるリスクは,精神疾患 (44.6%) で最も高く,次にシングル (10.3%) と失業 (3.0%) であった.
結論:
- 自殺予防の取り組みは,精神疾患で入院している人を優先すべきです.
- 一般の人々における精神障害の検出と治療の改善は,自殺を減らすための重要な戦略です.
- 自殺に対する社会経済的リスク因子の影響は,根本的な精神的健康状態に調整されていない場合,過大評価される可能性があります.
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