精神科・心療内科における自殺実態調査

A Survey of Suicide Cases in Psychiatry and Psychosomatic Medicine Clinical Settings

抄録

　福島県内の全精神科・心療内科110機関を対象として，各医療機関に通院または入院中であった患者の自殺者の調査を後方視的に行った。84機関(76.4％)が回答し，6か月の観察期間中，男性21人，女性25人の自殺者が報告された。警察庁自殺統計による同期間の自殺者数と比較して自殺者に占める受診患者の割合を求めると，男性17.5％，女性41.8％と推計され，男女で有意差が認められた(p＜.00001)。患者調査や有病率調査の結果から，男性において受診患者と未受診罹患者の自殺率に大きな開きがあると考えられ，その背景について，受診によってもたらされる環境変化が寄与している可能性について考察した。

　A retrospective survey of suicide cases in psychiatry and psychosomatic medicine clinical settings was conducted in Fukushima, just before the Higashi-Nihon Earthquake. Out of 110 clinics and hospitals, 84 responded (76.4%). During the observational period of six months, 21 male and 25 female suicide cases were reported. With total suicide numbers obtained from Suicide Statistics by the National Police Agency, the ratio of patients to total suicide cases were estimated, resulting in a ratio of 17.5% in men and 41.8% in women. This sex difference of the ratio was statistically significant (p＜.00001). With data from the Patient Survey(by the Ministry of Health, Labor and Welfare) and a previous study of morbidity, the suicide rates of treated and non-treated patients were estimated. The results showed a much lower rate only in male treated, rather than non-treated, patients. If this difference was due to a treatment effect, as it was observed only in men, it may be due not to medication but to other factors, such as social supports obtained after diagnosis of psychiatric disorders.