自殺予防戦略:体系的なレビュー
J John Mann1, Alan Apter, Jose Bertolote
1New York State Psychiatric Institute, Division of Neuroscience, New York, NY 10032, USA. jjm@columbia.edu
JAMA
|October 27, 2005
まとめ
医者の教育と致命的な手段へのアクセスを制限することで,自殺率を効果的に減らすことができます. 他の自殺予防戦略の有効性を確認するためにさらなる研究が必要である.
科学分野:
- 公衆衛生は公衆衛生である.
- 精神科医は精神病を患っている.
- エピデミオロジー エピデミオロジー
背景:
- 自殺は2002年に世界中で推定87万7千人の死亡を引き起こした.
- 先進国では国家的な自殺予防計画があるが,その有効性はめったに評価されない.
- 具体的な介入の評価は,自殺予防におけるリソースの割り当てを最適化するために極めて重要です.
研究 の 目的:
- 特定の自殺予防介入の有効性を支持する証拠を評価する.
- 将来の自殺予防プログラムと研究のための勧告を提供すること.
主な方法:
- MEDLINE,コクラン図書館,PsychINFOのデータベース (1966年6月~2005年6月) で包括的な文献検索が行われました.
- 研究は,公衆/専門教育,スクリーニング,精神科治療,手段の制限,メディアの報道を含む介入を評価した.
- データ抽出は,自殺行動と中間的結果に焦点を当て,研究異質性のためにナラティブ・シンセシスが行われました.
主要な成果:
- 鬱病の認識と治療に関する医師教育は,自殺予防に有効であることが判明しました.
- 致死的な手段へのアクセスを制限することも,効果的な自殺予防戦略として特定されました.
- 公共教育,スクリーニングプログラム,メディアガイドラインは,その有効性を確認するためにさらなる調査を必要とします.
結論:
- 医者の教育と致死的な方法へのアクセスを制限することは,自殺率を下げるための根拠に基づいた戦略です.
- 他の自殺予防介入の有効性を確立するために,さらなる研究が必要である.
- 自殺予防プログラムの有効な構成要素を特定することは,効率的な資源利用に不可欠です.
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