自杀前的初级保健咨询模式:一个全国代表性的病例控制研究研究
Danah Alothman1, Sarah Lewis1, Andrew W Fogarty1
1School of Medicine, University of Nottingham, Nottingham.
概括
频繁的初级保健咨询,特别是在最后一年每月一次,在所有人口统计数据中显著增加了自杀风险. 这突显了干预自杀预防工作的关键窗口.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 心理健康研究 心理健康研究
背景情况:
- 初级医疗保健咨询提供了一个关键机会,用于识别自杀风险较高的个体.
- 了解自杀前的咨询模式对于开发有效的早期干预策略至关重要.
研究的目的:
- 分析自杀前五年的初级保健咨询频率和原因.
- 根据咨询模式,确定特定的患者群体具有更高的自杀风险.
主要方法:
- 一项使用来自英格兰 (2001-2019) 的电子健康记录的病例控制研究.
- 涉及14,515名因自杀而死亡的患者和580,159名匹配的活体对照.
- 分析了咨询模式和寻求护理的原因.
主要成果:
- 高频率的咨询 (在最后一年超过每月一次) 与自杀风险增加密切相关 (OR 5.88).
- 这种关联在所有社会人口统计学群体和精神病相关疾病状态中都存在.
- 女性,年轻人 (15-45岁),社会经济贫困程度较低的人以及患有精神疾病的个人在高频率咨询时风险增加得更明显.
结论:
- 增加初级保健咨询的频率,特别是不断升级或超过月度访问,是自杀风险增加的重要指标.
- 这种风险上升是独立于社会人口统计学因素以及被诊断出精神疾病的存在或不存在.
- 识别这些高风险的咨询模式可以在初级保健机构中为有针对性的自杀预防策略提供信息.
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