デンマーク の 神経 疾患 と 自殺 による 死 の 関係
Annette Erlangsen1,2,3,4, Egon Stenager5,6,7,8, Yeates Conwell9
1Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.
JAMA
|February 5, 2020
まとめ
神経学的障害を持つ人は 一般人よりも高い自殺率を持っています このリスクは,特にハンティントン病や動脈縮性硬化症のような疾患では,診断後すぐに上昇します.
科学分野:
- 神経学
- 精神科
- 公衆衛生
背景:
- 神経学的障害は自殺のリスクの増加と関連しています.
- 様々な神経疾患の総合的な評価が必要である.
研究 の 目的:
- 神経学的障害を持つ人々の自殺率を一般の人々と比較して調査する.
- 神経学的診断と自殺の間の時間的関連を調べる
主な方法:
- デンマーク (1980年−2016年) の全国の遡及コホート研究で,730万人を対象とした.
- 神経学的障害の医療記録の分析と 自殺関連データ
- 調整された発生率比率 (IRR) は,ポアソン回帰を用いて推定された.
主要な成果:
- 神経学的障害を持つ個人は1. 8倍高い自殺率 (IRR=1. 8) を示した.
- アミオトロフィック横筋硬化症 (4. 9),ハンティントン病 (4. 9),多発性硬化症 (2. 2),頭部損傷 (1. 7), (1. 7),脳卒中 (1. 3) の場合,IRRが上昇した.
- 自殺リスクは,診断後最初の1〜3ヶ月で最高であった (IRR=3. 1),時間が経つにつれて減少したが,依然として高かった.
結論:
- 神経障害と診断された人々の自殺率はかなり高い.
- 全体的な絶対リスクの差は小さいが,特定の症状と診断後の早期の期間は,標的を絞った注意を払う必要がある.
- この発見は神経疾患の患者に対する メンタルヘルス支援の重要性を強調しています
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