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Abstract
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BACKGROUND: Suicide in older adults is an important public issue globally, but large-scale studies of the physical and mental diagnoses before suicidal death are lacking. The study aimed to reveal the medical diagnoses before suicidal death and estimate the trends of associated physical illnesses and mental disorders with suicide over the years.
METHODS: This was a national data linkage study. Cause of Death Data and the National Health Insurance Research Database (NHIRD) were used to collect the medical diagnosis of suicide patients within a year prior to death; a control group was paired by 10 times the amount. Logistic regression was used to calculate the odds ratios (ORs), and the ORs and prevalence were used to calculate the population attributable fraction (PAF) between two time periods of 2006 to 2010 and 2011 to 2015. The analysis were conducted in two groups of people: the outpatient and emergency service users and the inpatient service users.
RESULTS: Among out-patient and emergency service users, the diagnoses of suicide group ranking by PAF index from high to low were as follows: hypertensive disease (OR = 2.33, 95% CI = 2.19-2.46, PAF = 0.31), neurotic disorders & personality disorders (OR = 6.12, 95% CI = 5.74-6.53, PAF = 0.28), disorders of the eye and adnexa (OR = 2.17, 95% CI = 2.05-2.3, PAF = 0.25), gastric and duodenal ulcer (OR = 3.31, 95% CI = 3.10-3.53, PAF =0.19), and depressive disorders (OR = 10.58, 95% CI = 9.72- 11.52, PAF = 0.18). The above ranking orders and the odds were similarly presented during 2011-2015 period. For inpatient diagnoses prior to suicide, malignant neoplasms and nephritis or other kidney diseases were two different diagnoses that distinct from outpatient/emergency group of patients.
CONCLUSIONS: Our study is the first national data linkage analysis of medical diagnosis prior to suicide death in the elderly. The older adults with diagnoses of neurotic disorders & personality disorders, depressive disorders, cancer, renal disease, hypertensive disease, or pneumonia, are associated with an increased risk of suicide and need special attention.
Language: en |