自殺行動と関連する要因について—精神科救急患者レジストリを用いた臨床特徴の解析

Clinical Features Related to Suicidal Behavior in Patients with Suicidal Ideation:An analysis of a registry of patients requiring psychiatric emergency care

抄録　【目的】自殺念慮を有する者のうち，実際に自殺行動に至る要因を明らかにすること。【方法】患者レジストリを用い，自殺念慮を有する全入院者(797名)のうち，実際に自殺行動に至った患者(自殺企図群)の臨床特徴をそれ以外の患者(自殺念慮群)と比較した。【結果】自殺企図群において入院前の精神科通院(66.0%)，自立支援医療や障害年金などの制度利用の割合(43.8%)が自殺念慮群(78.3%，56.9%)に比べ有意に低かった。【考察】自殺企図群では精神科医療や社会的支援とのつながりが弱くconnectednessに課題を有し，予防的観点から自殺念慮を有する者を適切な支援に結び付けることの重要性が示された。

　［Purpose］We examined the clinical factors that relate to suicidal behavior among those with suicidal ideation.［Method］Using the inpatient registry, we assessed all patients admitted with suicidal ideation(n＝798)in the psychiatric emergency ward of Numazu Chuo Hospital. We compared the clinical characteristics of patients with suicidal ideation who committed suicide(Suicide action group)with other patients(Suicide ideation group).［Results］The proportion of psychiatric visits in the suicide action group prior to hospitalization was significantly lower than the suicide ideation group(66.0% vs. 78.3%). The rate of use of social support or welfare systems such as “System of Medical Payment for Services and Supports for Persons with Disabilities” or “disability pensions” was also significantly lower in the suicide action group compared to the suicide ideation group(43.8% vs. 56.9%).［Discussion］Patients who commit suicide showed less association with psychiatric care and social support, indicating weak “Connectedness.” Providing appropriate support for people with suicidal ideation can help prevent suicide in the future.