The epidemiology of suicide and attempted suicide in Dutch general practice 1983-2003

被引：33

作者：

Marquet R.L. ^{[1
]}

Bartelds A.I.M. ^{[1
]}

Kerkhof A.J.F.M. ^{[2
,3
]}

Schellevis F.G. ^{[1
]}

Van Der Zee J. ^{[1
]}

机构：

[1] Netherlands Institute of Health Services Research (NIVEL), 3500 BN, Utrecht

[2] Department of Clinical Psychology, Free University Amsterdam, 1081 BT Amsterdam

[3] Research Institute Psychology and Health, Utrecht

来源：

BMC Family Practice | / 6卷 / 1期

关键词：

General Practitioner; Suicidal Ideation; Suicide Attempt; Depressed Patient; Mental Health Professional;

D O I：

10.1186/1471-2296-6-45

中图分类号：

学科分类号：

摘要：

Background: Many patients attempting or committing suicide consult their general practitioner (GP) in the preceding period, indicating that GPs might play an important role in prevention. The aim of the present study was to analyse the epidemiology of suicidal behaviour in Dutch General Practice in order to find possible clues for prevention. Method: Description of trends in suicide and suicide attempts occurring from 1983-2003 in the Dutch General Practice Sentinel Network, representing 1% of the Dutch population. The data were analysed with regard to: 1) suicidal behaviour trends and their association with household situation; 2) presence of depression, treatment of depression and referral rate by GPs; 3) contact with GP before suicide or suicide attempt and discussion of suicidal ideation. Results: Between 1983 and 2003 the annual number of suicide and suicide attempts decreased by 50%. Sixty percent of the patients who committed or attempted suicide were diagnosed as depressed, of whom 91% were treated by their GP with an antidepressant. Living alone was a risk factor for suicide (odds ratio 1.99; 95% CI 1.50 to 2.64), whereas living in a household of 3 or more persons was a relative risk for a suicide attempt (odds ratio 1.81; 95% CI 1.34 to 2.46). Referral to a psychiatrist or other mental health professionals occurred in 65% of the cases. GPs recalled having discussed suicidal ideation in only 7% of the cases, and in retrospect estimated that they had foreseen suicide or suicide attempts in 31% and 22% of the cases, respectively, if there had been contact in the preceding month. Conclusion: With regard to the prescription of antidepressants and referral of suicidal patients to a psychiatrist, Dutch GPs fulfil their role as gatekeeper satisfactorily. However, since few patients discuss their suicidal ideation with their GP, there is room for improvement. GPs should take the lead to make this subject debatable. It may improve early recognition of depressed patients at risk and accelerate their referral to mental health professionals. © 2005 Marquet et al; licensee BioMed Central Ltd.

引用

共 23 条

[1]

Chishti P., Stone D.H., Corcoran P., Williamson E., Petridou E., Suicide mortality in the European Union, Eur J Public Health, 3, pp. 108-114, (2003)

[2]

Arensman E., Kerkhof A.J.F.M., Hengeveld M.W., Mulder J.D., Medically treated suicide attempts: A four years monitoring study of the epidemiology in the Netherlands, J Epidemiol Community Health, 49, pp. 285-289, (1995)

[3]

Hamilton N.G., Suicide prevention in primary care, Postgrad Med, 108, pp. 81-87, (2000)

[4]

Diekstra R.F.W., Van Egmond M., Suicide and attempted suicide in general practice, 1979-1986, Acta Psychiatr Scand, 79, pp. 268-275, (1989)

[5]

Luoma J.B., Martin C.E., Pearson J.L., Contact with mental and primary care providers before suicide: A review of the evidence, Am J Psychiatry, 159, pp. 909-916, (2002)

[6]

Freedenthal S., Primary care and suicide prevention, Am J Psychiatry, 160, pp. 1012-1013, (2003)

[7]

Marquet R.L., Bartelds A., Visser G.J., Spreeuwenberg P., Peters L., Twenty five years of requests for euthanasia and physician assisted suicide in Dutch general practice: Trend analysis, BMJ, 327, pp. 201-202, (2003)

[8]

Donker G.A., Spreeuwenberg P., Bartelds A.I.M., Van Der Velden K., Foets M., Hormone replacement therapy: Changes in frequency and type of prescription by Dutch GPs during the last decade of the millennium, Fam Pract, 17, pp. 508-513, (2000)

[9]

Fleming D.M., Zambon M., Bartelds A.I.M., De Jong J.C., The duration and magnitude of influenza epidemics: A study of surveillance data from sentinel general practices in England, Wales and the Netherlands, Eur J Epidemiol, 15, pp. 467-473, (1999)

[10]

Verhaak P.F.M., Bartelds A.I.M., Schellevis F.G., How do GPs treat new cases of depression?, Huisarts en Wetenschap (General Practitioner and Science), 45, pp. 722-726, (2002)

← 1 2 3 →