統合失調症圏と感情障害圏の外来患者における自殺の特徴と比較

Characteristics of Outpatients with Schizophrenia and Affective Disorder who Commit Suicide

抄録

　5年間の外来患者17,021名で，計65名(0.38％)が自殺既遂していた。統合失調症圏(F2群)と感情障害圏(F3群)の患者計45名(F2群：19名，F3群：26名)について，発症から既遂までの期間は，F3群は1年から3年未満でF2群より自殺者が多く，F2群は5年以上でF3群より自殺者が多かった。F2群がF3群に比較し重度の不眠を呈していた。抑うつ気分の割合は両群とも70％以上と高い一方で，自殺念慮を表出する割合は約30％と低かった。F2群では約80％，F3群では約70％が，最終受診時の精神状態は不良であった。今回の調査研究は，わが国の精神障害を有する自殺者の特徴を知るうえで有意義と考えられる。

　The treatment of mental disorders is thought to be effective for preventing suicide. Over 5 years, 65 outpatients of our mental hospital committed suicide. Most of these patients suffered from schizophrenia (F2 group：19 patients) and affective disorder (F3 group：26 patients). We assessed the tendency to commit suicide in 45 patients from these 2 groups and compared the values obtained. From the onset of disease until suicide, the frequency of suicide attempts was significantly higher in the F3 group from 1 to 3 years after onset of disease, while it was significantly higher in the F2 group over a span of 5 years. During the last consultation, the F2 group showed more severe signs of sleeplessness than the F3 group. Over 70% of the patients in both groups complained of a depressive mood, but an inclination to suicide was observed only in about 30% of the patients in both groups, suggesting that the prevention of suicide is difficult. Many patients in both groups committed suicide when their mental condition was found to be deteriorating at the last consultation, although quite a few suicides were committed throughout the disease course. In order to prevent suicide, we believe that during consultation, patients should be queried about any depressive mood, sleeplessness, and wish to commit suicide.