题名

Psychiatric Diagnoses and Gender Differences in Patients Admitted for Pesticide Suicide: An 11-year Retrospective Study in a General Hospital in Taiwan

并列篇名

因農藥自殺的住院病人之精神科診斷及性別差異:在台灣一家綜合醫院11年的回溯性研究

作者

李晉邦(Chin-Pang Lee);顏宗海(Tzung-Hai Yen);莊永毓(Yeong-Yuh Juang);林哲名(Chemin Lin);林杰樑(Ja-Liang Lin);李淑花(Shwu-Hua Lee)

关键词

suicide ; pesticides ; psychiatric diagnosis ; gender ; 自殺 ; 農藥 ; 精神科診斷 ; 性別

期刊名称

台灣精神醫學

卷期/出版年月

31卷2期(2017 / 06 / 01)

页次

140 - 149+iii

内容语文

英文

中文摘要

Objectives: Pesticide poisoning is a common method of suicide in Taiwan. In this study, we intended to study patients’ underlying psychiatric diagnoses and gender differences. Methods: We conducted a retrospective observational study on inpatients who had suicide attempts with pesticide-poisoning from 2000 to 2011. The patients were referred to the psychiatric consultation staff, and their diagnoses were made according to DSM-IV. Patients’ demographic and clinical variables, psychiatric diagnoses, and concurrent life stress were obtained and analyzed. Results: Among 177 patients, the majority (77%) of the patients with attempted suicide used organophosphate poisoning. The most frequent diagnoses were depressive disorders (58%), substance use disorders (35%), and adjustment disorder (28%). The male-to-female gender ratio was 2. The male patients had significantly more substance use disorder, particularly alcohol use disorder, than female counterparts (p < 0.01). Patients’ major life stressors were illness, couple conflicts, layoff from jobs, parent-child conflict, and economic stress. Among concurrent life stressors, male patients had significantly more layoff reasons than female patients (p < 0.05). Female patients had significantly more often couple conflicts than male patients (p < 0.05). Conclusion: Patients’ gender differences existed in attempted suicide with pesticide poisoning, in demographic profiles and psychiatric diagnoses. Suicide risk assessment and prevention should therefore be considered the patients’ factor of gender.

英文摘要

目的:雖然在台灣,農藥中毒是一種常見的自殺方法,然而相關的精神科診斷及性別差異仍待研究。方法:我們執行一項針對以農藥中毒之自殺方法而住院的病人的病歷回溯性研究,時間為2000至2011年。針對有接受精神科照會的病病人,收集DSM-IV診斷、人口學資料、臨床資料、自殺當時的生活壓力等變數,進而分析。結果:在177位病人中,大多數(77%)以有機磷中毒方式自殺;憂鬱症佔58%,物質使用疾患佔35%,適應障礙佔28%。男女性別比為2。相較於女性,男性有較多的物質使用疾患,特別是酒精使用疾患(p < 0.01)。主要的生活壓力事件為疾病、伴侶衝突、失業、親子衝突、及經濟壓力。在生活壓力事件當中,男性有較多的失業,女性有較多的伴侶衝突(p < 0.05)。結論:以農藥中毒之自殺方法而住院的病人當中,在人口學資料及精神科診斷方面有性別的差異。因此,自殺風險的評估及防治應考慮性別因素。

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. Brett, T,Arnold-Reed, DE,Troeung, L(2014).Multimorbidity in a marginalised, street-health Australian population: a retrospective cohort study.BMJ Open,4,e005461.
  2. Cha, ES,Khang, YH,Lee, WJ(2014).Mortality from and in- cidence of pesticide poisoning in South Korea: find- ings from National Death and Health Utilization Data between 2006 and 2010.PLOS One,9,e95299.
  3. Chang, SS,Lu, TH,Eddleston, M(2012).Factors asso- ciated with the decline in suicide by pesticide poison- ing in Taiwan: a time trend analysis, 1987-2010.Clin Тоxісol,50,471-480.
  4. Chang, SS,Lu, TH,Sterne, JA(2012).The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis.BMC Public Health,12,260.
  5. Chang, SS,Sterne, JA,Lu, TH(2010).'Hidden’ suicides amongst deaths certified as undetermined intent, ac- cident by pesticide poisoning and accident by suffo- cation in Taiwan.Soc Psychiatry Psychiatr Epidemiol,45,143-152.
  6. Chen, CF,Lin, HL,Chou, HY(2015).Acute pesticide poisoning outcomes: a nationwide study in Taiwan.Emerg Med J,32,226-231.
  7. Chien, WC,Lin, JD,Lai, CH(2011).Trends in poison- ing hospitalization and mortality in Taiwan, 1999- 2008: a retrospective analysis.BMC Public Health,11,703.
  8. Eddleston, M,Eyer, P,Worek, F(2005).Differences be- tween organophosphorus insecticides in human self- poisoning: a prospective cohort study.Lancet,366,1452-1459.
  9. First, MB,Spitzer, RL,Gibbon, M(2002).Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P).New York:Biometrics Research, New York State Psychiatric Institute.
  10. Gunnell, D,Eddleston, M(2003).Suicide by intentional in- gestion of pesticides: a continuing tragedy in devel- oping countries.Int J Epidemiol,32,902-909.
  11. Harrell, FEJ,Dupont, Charles(2016).Harrell FEJ, with contributions from Charles Dupont and many others. Hmisc: Harrell Miscellaneous. R package version 3.17-4. 2016..
  12. Hawton, K(2000).Sex and suicide. Gender differences in suicidal behaviour.Br J Psychiatry,177,484-485.
  13. Hsu, C,Tsai, M,Chen, K(2013).Can mortality from agricultural pesticide poisoning be predicted in the emergency department? findings from a hospital- based study in eastern Taiwan.Tzu Chi Medical Journal,25,32-38.
  14. Kuo, CJ,Gunnell, D,Chen, CC(2012).Suicide and non-suicide mortality after self- harm in Taipei City, Taiwan.Br J Psychiatry,200,405-411.
  15. Lee, HL,Lin, HJ,Yeh, ST(2008).Presentations of pa- tients of poisoning and predictors of poisoning-relat- ed fatality: findings from a hospital-based prospec- tive study.BMC Public Health,8,7.
  16. Lin, JL,Lin-Tan, DT,Chen, KH(2011).Improved sur- vival in severe paraquat poisoning with repeated pulse therapy of cyclophosphamide and steroids.Intensive Care Med,37,1006-1013.
  17. Lin, TJ,Walter, FG,Hung, DZ(2008).Epidemiology of organophosphate pesticide poisoning in Taiwan.Clin Тоxісol,46,794-801.
  18. Linn, BS,Linn, MW,Gurel, L(1968).Cumulative illness rat- ing scale.J Am Geriatr Soc,16,622-626.
  19. Liu, SH,Lin, JL,Weng, CH(2012).Heart rate-corrected QT interval helps predict mortality after intentional organophosphate poisoning.PLOS One,7,e36576.
  20. Moller-Leimkuhler, AM(2003).The gender gap in suicide and premature death or: why are men so vulnerable?.Eur Arch Psychiatry Clin Neurosci,253,1-8.
  21. Moscicki, EK(1994).Gender differences in completed and attempted suicides.Ann Epidemiol,4,152-158.
  22. O’Halloran, J,Miller, GC,Britt, H(2004).Defining chronic conditions for primary care with ICPC-2.Fam Pract,21,381-386.
  23. Torchiano, M(2016).Torchiano M: Efficient Effect Size Computation. R package version 0.6.4. 2016..
  24. Toro, K,Pollak, S(2009).Complex suicide versus compli- cated suicide.Forensic Sci Int,184,6-9.
  25. Tsai, JR,Sheu, CC,Cheng, MH(2007).Organophosphate poisoning: 10 years of experience in southern Taiwan.Kaohsiung J Med Sci,23,112-119.
  26. Wen, H,Pai, L,Lu, R(1987).The research of the life stress perception and the related background factors of the adult residents in Cu-Tin, Lon-Sun sections of the Taipei City.J Med Sci,8,81-92.
  27. World Health Organization(2014).Preventing Suicide: A Global Imperative.Geneva, Switzerland:World Health Organization.
  28. Zhang, M,Fang, X,Zhou, L(2013).Pesticide poisoning in Zhejiang, China: a retrospective analysis of adult cases registration by occupational disease surveil- lance and reporting systems from 2006 to 2010.BMJ Open,3,e003510.
被引用次数
  1. Gunnell, David,Chang, Shu-Sen(2019).Banning Paraquat Would Prevent Nearly 200 Deaths from Suicide per Year in Taiwan.臺灣精神醫學,33(3),119-121.