University of Split. School of Medicine. Forensic medicine.
Abstract
Cilj istraživanja: Suicid je čin svjesnog i namjernog oduzimanja vlastitog života. Događaj koji pogađa brojne zajednice diljem svijeta, zato smo željeli istražiti kolika je stopa suicida u Splitsko-dalmatinskoj županiji, koji su bili čimbenici rizika i možemo li primijeniti kakve metode prevencije koje postoje u zemljama s nižom stopom samoubojstava.
Ispitanici i metode: U ovoj retrospektivnoj studiji obrađivali smo podatke prikupljene o 219 žrtava suicida na području Splitsko-dalmatinske županije u razdoblju 2011.-2015. godine. Za sve ispitanike smo zabilježili spol i dob, na koji način su izvršili suicid te u kojem razdoblju godine. Također, za 30 ispitanika smo uspjeli prikupiti podatke o razlozima prijašnjih hospitalizacija te uvid u njihove povijesti bolesti iz kojih smo saznali rizične čimbenike žrtava.
Rezultati: Prosječna stopa suicida za promatrano razdoblje iznosi 9,7 osoba/100.000 stanovnika, te je uočen postupni pad stope kroz godine, ali bez statističke značajnosti. Žrtve suicida su češće bili muškarci (71%) uz prosječno mlađu životnu dob prilikom izvršenja (52,06±18,49) nego žene (29%, 60,16±19,09). Obe razlike su statistički značajne (razlika u udjelu spolova P<0,001; razlika u dobi P=0,004). Najčešći način izvršenja suicida je vješanje (49%), a zatim slijede skok s visine (18%) i vatreno oružje (14%). Žene češće biraju način samoubojstva utapanjem i samootrovanjem u odnosu na muškarce, a muškarci češće biraju vatrenim oružjem u odnosu na žene. Najveći broj suicida dogodio se u II. (travanj-lipanj) i III. (srpanj-rujan) kvartalu bez statistički značajne razlike. Najčešći uzrok hospitalizacije bila je shizofrenija (39%), zatim poremećaji raspoloženja (16%), pa neurotski i somatoformni poremećaji izazvani stresom (14%) te zatim poremećaji ličnosti i ponašanja u odraslih (7%). Više pacijenata u svojoj povijesti bolesti imalo je zabilježeno i poremećaje ponašanja uzrokovano uzimanjem alkohola (9%) ili opijata (7%). Čak 43% ispitanika imalo je zabilježeno više komorbiditeta u povijesti bolesti.
Zaključak: Suicid češće i u prosječno mlađoj dobi čine muškarci. Porastom dobi udio spolova se izjednačuje. Muškarci češće koriste letalnije metode suicida nego žene. Suicidi se češće događaju u toplijim mjesecima godine (travanj-rujan). Rizične skupine psihijatrijskih bolesnika su oboljeli od shizofrenije, poremećaja raspoloženja, oni s neurotskim i somatoformnim poremećajima izazvanim stresom te oni s poremećajima ličnosti. Jako rizičan faktor imaju i oni s poremećajem ponašanja uzrokovanog alkoholom i opijatima.Objective: Suicide is an act of intentionally causing one's own death. It is phenomenon that affects all the communities of the world so we wanted to investigate what was the suicide rate and risk factors that affected on it and to determine if there were some prevention methods in the countries with smaller rate of suicides that we could apply in our health care system.
Subjects and methods: In this retrospective study we analyzed the data we collected from 219 suicide victims. For every person we recorded their gender, age, the way they killed themselves and the time of the year when suicide happened. Also, for 30 of them we managed to collect the data about their history of illness and the insight in their personal and family anamnesis from where we have found out what risk factors they had.
Results: An average suicide rate in the period of 2011-2015 was 9,7/100.000 and it was noticed that suicide rate is decreasing but we have not found statistically positive correlation. Suicide victims were more often men (71%) than women (29%) and that difference was statistically significant (P<0,001). Men commited suicide in earlier age than women did and that result was also statistically significant (P=0,004). The most used methods of suicide were (ordered by frequency): hanging (49%), falls (18%) and firearms (14). Women commited suicide more frequently by drowning and poisoning, while men commited it more by firearms. Most of the suicides happened in the second (April-June) and the third (July-September) quarters of the year. The most frequent reason for hospitalization was schizophrenia (39%), than mood disorders (16%), than neurotic and somatophormic disorders caused by stress (14%) and finally personality disorder (7%). Several patients had behavior disorders caused by alcohol (9%) and opiates (7%). We recorded comorbidity in 43% of patients.
Conclusion: Most of the suicides are commited by middle-aged men. In the elderly men and women commit suicide equally. Men use more lethal methods than women do. Most of the suicides happen in the warmer months (April-September). Groups of the psychiatric patients with high suicidal risk are those who suffer from schizophrenia, mood disordes, than people who have neurotic and somatophormic disorder caused by stress and finally those with personality disorder. People who have behaviour disorder caused by alcohol and opiates as well, have high suicidal risk
