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自杀
Suicide


Seena Fazel ... 其他 • 2020.01.16
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全球每年约有80万人自杀身亡,占死亡总人数的1.5%1。自杀是北美洲的第十大死因,也是全球15~24岁人群的最大死因。

 

流行病学


世界卫生组织(WHO)估计2016年的自杀率为10.6/10万,其中80%发生于低收入和中等收入国家2。在WHO的六个区域中,自杀率最高的是欧洲,最低的是东地中海(包括中东),这两个区域的自杀率相差4倍。对这一差异的解释包括以下几方面的差异:自杀的分类、对自杀的社会文化态度、接触到致命自杀手段的情况以及是否对精神疾病采取充分治疗。全球范围内的自杀率因年龄和性别而异,老年人的自杀率最高,男性的自杀率(15.6/10万)高于女性(7.0/10万)2。近几十年来,上述大部分区域的自杀率持续下降,2000—2016年估计下降了18%。

但美洲的情况是例外;美国的自杀率自2000年以来每年上升1.5%3,45~64岁男性的自杀率从1999年的21/10万上升至2017年的30/10万4

生态学研究可以解释国家内部随时间推移表现出的趋势;这些研究提示针对酒类制定的限制政策在降低自杀率方面发挥了作用5。此外,自杀率的变化也归因于对常用自杀手段做出的限制,例如英国从20世纪60年代开始逐渐去除民用燃气内的有毒气体(即由于改用天然气,燃气内的一氧化碳含量逐渐减少,并最终被去除)6,俄罗斯减少酒精饮料的供应7,以及美国各州对枪支的限制8





作者信息

Seena Fazel, M.D., and Bo Runeson, M.D., Ph.D.
From the Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom (S.F.); and the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm (B.R.). Address reprint requests to Dr. Fazel at the Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom, or at seena.fazel@psych.ox.ac.uk.

 

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