PDF(Pubmed)
Abstract：
Nonfatal suicidality is the most robust predictor of suicide death. However, only ~10% of those who survive an attempt go on to die by suicide. Moreover, ~50% of suicide deaths occur in the absence of prior known attempts, suggesting risks other than nonfatal suicide attempt need to be identified. We studied data from 4,000 population-ascertained suicide deaths and 26,191 population controls to improve understanding of risks leading to suicide death. This study included 2,253 suicide deaths and 3,375 controls with evidence of nonfatal suicidality (SUI_SI/SB and CTL_SI/SB) from diagnostic codes and natural language processing of electronic health records notes. Characteristics of these groups were compared to 1,669 suicides with no prior nonfatal SI/SB (SUI_None) and 22,816 controls with no lifetime suicidality (CTL_None). The SUI_None and CTL_None groups had fewer diagnoses and were older than SUI_SI/SB and CTL_SI/SB. Mental health diagnoses were far less common in both the SUI_None and CTL_None groups; mental health problems were less associated with suicide death than with presence of SI/SB. Physical health diagnoses were conversely more often associated with risk of suicide death than with presence of SI/SB. Pending replication, results indicate highly significant clinical differences among suicide deaths with versus without prior nonfatal SI/SB.
摘要：
非致命性自杀是自杀死亡的最可靠预测因素。然而,只有~10%的人在一次尝试中幸存下来后会自杀而死。此外，50%的自杀死亡发生在没有事先已知的尝试的情况下，提示非致命性自杀企图以外的其他风险需要确定.我们研究了4,000名人口确定的自杀死亡和26,191名人口对照的数据，以提高对导致自杀死亡风险的理解。这项研究包括2,253例自杀死亡和3,375例对照，并从诊断代码和电子健康记录笔记的自然语言处理中获得了非致命自杀（SUI_SI/SB和CTL_SI/SB）的证据。将这些组的特征与没有先前非致命性SI/SB（SUI_None）的1,669例自杀和没有终生自杀性（CTL_None）的22,816例对照进行了比较。SUI_None和CTL_None组的诊断较少，并且年龄大于SUI_SI/SB和CTL_SI/SB。在SUI_None和CTL_None组中，心理健康诊断都不那么普遍；与SI/SB的存在相比，心理健康问题与自杀死亡的相关性较小。与SI/SB的存在相比，身体健康诊断与自杀死亡风险的相关性更高。待复制,结果表明,与没有既往非致命性SI/SB的自杀死亡相比,临床上有非常显著的差异.
