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Citation
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Li S, Yang XM, Wang D, Fan RX, Tian SL, Wang RK, Xiang H, Zhang Q, Liu YY, Liu X. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54(1): 142-147. |
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Abstract
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OBJECTIVE: To prospectively explore the risk factors of suicide in patients with schizophrenia.
METHODS: Data on schizophrenia patients in Sichuan Province between 2006 and 2018 were obtained from the National Severe Mental Disorders Information System, and the Cox proportional hazards regression model was used to explore for risk factors for suicide in schizophrenia patients.
RESULT: A total of 170006 patients with schizophrenia were included in the study. At the end of the follow-up period, 160570 patients were alive and 9436 died from various causes, 929 of which being suicide deaths, resulting in a suicide rate of 223.61/100, 000 person-years. The Cox proportional hazards regression model suggested that risk factors for suicide in patients with schizophrenia included poverty ( HR=1.20, 95% CI: 1.02-1.41), higher education level (primary school [ HR=1.32, 95% CI: 1.09-1.60], middle school [ HR=1.40, 95% CI: 1.14-1.73], high school and above [ HR=1.93, 95% CI: 1.49-2.52]) in comparison with illiteracy and semi-literacy, suicide attempts ( HR=2.70, 95% CI: 1.70-4.29), strict medication compliance ( HR=1.91, 95% CI: 1.66-2.20), history of antipsychotic drug therapy ( HR=1.42, 95% CI: 1.06-1.90), younger age group of patients of 46-60 ( HR=1.95, 95% CI: 1.60-2.39), 31-45 ( HR=3.61, 95% CI: 2.92-4.47), and 15-30 ( HR=12.37, 95% CI: 9.69-15.78) compared with the 61-90 age group, and doing agriculture jobs ( HR=1.36, 95% CI: 1.13-1.65).
CONCLUSION: Young and middle-aged schizophrenia patients with higher education levels, especially those with a history of suicide attempts, are at high risk for suicide. Focused interventions should be directed at high-risk groups to reduce suicide deaths in patients with schizophrenia.
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目的 前瞻性探索精神分裂症患者因自杀死亡的危险因素。 方法 从四川省严重精神障碍综合管理信息系统中获得四川省2006-2018年的精神分裂症患者，使用Cox比例风险回归模型探索精神分裂症患者自杀的危险因素。 结果 研究共纳入了170006名精神分裂症患者。随访期结束后有160570人存活，9436人由于各种原因死亡，其中929人死于自杀,自杀发生率为223.61/100000人年。Cox比例风险回归模型提示：贫困（HR=1.20，95%CI：1.02～1.41）；与文盲与半文盲相比，较高的文化程度〔小学（HR=1.32，95%CI：1.09～1.60）、初中（HR=1.40，95%CI：1.14～1.73）、高中及以上（HR=1.93，95%CI：1.49～2.52）〕；自杀未遂（HR=2.70，95%CI：1.70～4.29）；服药依从性好（HR=1.91，95%CI：1.66～2.20）；存在抗精神药物治疗史（HR=1.42，95%CI：1.06～1.90）；与61～90岁年龄组相比，较小的年龄组46～60岁（HR=1.95，95%CI：1.60～2.39）、31～45岁（HR=3.61，95%CI：2.92～4.47）、15～30岁（HR=12.37，95%CI：9.69～15.78）；从事农业工作（HR=1.36，95%CI：1.13～1.65）是精神分裂症患者自杀的危险因素。 结论 较高文化程度的中青年精神分裂症患者，尤其是有过自杀未遂史的患者为自杀发生的高危人群，应针对高危人群进行重点干预以减少精神分裂症患者自杀死亡的发生。
Language: zh |