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Abstract
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BACKGROUND: The middle-aged population constitutes the majority of suicide deaths in terms of numbers. The study aimed to clarify the patterns of medical service utilization and diagnoses preceding incidents of suicide in middle-aged adults in Taiwan.
METHODS: A national study linked Cause of Death Data to the National Health Insurance Research Database to examine medical diagnoses of suicide patients aged 25 to 64. A 10:1 control group ratio, logistic regression, and population-attributable fraction analysis for 2011-2015 were used to focus on outpatient, emergency, and inpatient service users.
RESULTS: Among out-patient and emergency service users, the top 3 medical diagnoses of suicide group aged 25 to 44 ranking by PAF index were: neurotic disorders and personality disorders (OR = 10.9, 95% CI = 10.1-11.6, PAF = 0.27), depressive disorders (OR = 23.6, 95% CI = 21.7-25.6, PAF = 0.26), and episodic mood disorders (OR = 30.9, 95% CI = 27.8-34.3, PAF = 0.19). Among the suicide group aged 45 to 64, the top 3 diagnoses were: neurotic disorders and personality disorders (OR = 7.27, 95% CI = 6.9-7.7, PAF = 0.29), depressive disorders (OR = 17.9, 95% CI = 16.7-19.2, PAF = 0.28), and episodic mood disorders (OR = 22.9, 95% CI = 20.9-25.2, PAF = 0.19). Among in-patient services, the top 3 diagnoses of the suicide group aged 25 to 44 ranking by PAF index were: depressive disorders (OR = 78.2, 95% CI = 59.1-103.6, PAF = 0.06), episodic mood disorders (OR = 59.0, 95% CI = 45.5-78.0, PAF = 0.05), and schizophrenic disorder (OR = 29.0, 95% CI = 22.5-37.3, PAF = 0.03). Among the suicide group aged 45 to 64, the top 3 diagnoses were: hypertensive disease (OR = 4.8, 95% CI = 4.3-5.3, PAF = 0.07), depressive disorders (OR = 63.7, 95% CI = 50.4-80.5, PAF = 0.07), and diabetes (OR =5.8, 95% CI =5.1-6.4, PAF = 0.06).
CONCLUSIONS: Our study is the first national data linkage analysis of medical diagnoses preceding suicide deaths in middle-aged adults. The middle-aged adults with diagnoses of neurotic disorders & personality disorders, depressive disorders, episodic mood disorders, schizophrenic disorder, hypertensive disease, or diabetes, were associated with an increased risk of suicide and required special attention.
Language: en |