Citation

Hashimoto T, Ukai S, Takahashi S, Okumura M, Tsuji T, Naka T, Shinosaki K. Jpn. J. Gen. Hosp. Psychiatry 2012; 24(1): 33-39.

Vernacular Title

和歌山県立医科大学附属病院救命救急センターを受診した自殺企図者の特徴と過量服薬への介入の提案

Copyright

(Copyright © 2012)

DOI

10.11258/jjghp.24.33

PMID

unavailable

Abstract

In order to propose clinical intervention for suicide prevention, we examined the suicide attempters taken to the emergency room of Wakayama Medical University Hospital from July 2010 to March 2011. The total number of suicide attempters was 76, and 71% of them had overdosed. The number of repeating suicide attempters (5 or more times) was 18, and 83% of them had overdosed. Five attempters were pronounced dead by the time they arrived at the emergency room, and 4 of them had a history of overdose medication. Three of them were confirmed to have overdosed one time or more in the past year. In line with the preceding reports, overdose medication was most frequently employed among the suicide methods, and it seems to have been easily repeated. In addition, overdose medication may have a potential for leading to completed suicide, while its fatality rate is rather low. We have proposed an intervention to restrict prescription days and shorten the consultation interval for patients who have overdosed in the past year, and a system to share their information with emergency services, emergency medical institutions and family doctors.

Vernacular Abstract

自殺企図者の実態を把握し，救急医療，精神科医療を含む医療サイドから自殺対策の提言を行うことを目的に，和歌山県立医科大学附属病院救命救急センターを受診した全自殺企図者を調査した。9カ月の調査期間中に76名が受診し，そのうちの71％で過量服薬が認められた。5回以上の自殺企図歴のある患者は18名で，そのうちの83％で過量服薬が認められた。5名の自殺既遂者のうち4名は過量服薬による自殺企図歴があり，企図時期を特定できた3名は全員が過去1年以内に過量服薬をしていた。過量服薬による自殺企図は繰り返されやすく，それ自体の致命率は低いが，縦断的には既遂に至る可能性が高いと考えられた。自殺対策の方略として，過量服薬による企図歴がある患者に対する処方日数の制限・受診間隔の短縮と，救急隊，搬送先の医療機関，かかりつけの医療機関で情報を共有できるシステムの構築を提案した。