The lifetime prevalence of schizophrenia estimated from a
systematic review of 188 studies was 0Æ4% (Saha et al. 2005).
Similarly, the prevalence of schizophrenia in Taiwan estimated
from National Health Insurance (NHI) data was
0Æ44% (Chien et al. 2004). Schizophrenia influences not only
one’s cognition, emotions and social functions (American
Psychiatric Association 2000) but also the occurrence of
suicide attempts (Xiang et al. 2008, Robinson et al. 2010).
The lifetime suicide rate estimated from a review of 51
studies on patients with schizophrenia from Europe, North
America and Asia was around 5% (Hor & Taylor 2010). In
Taiwan, the suicide mortality of patients with schizophrenia
in 2007 was over three times higher than that in the general
population (Department of Health-Taiwan 2008). In Finland,
around 30% of 18,199 patients with schizophrenia repeated
suicide attempts between 1996 and 2003 (Haukka et al.
2008). These latter results indicate that health care providers
caring for patients with schizophrenia need to place a very
high priority on the risk of suicide attempts.
Suicidal risk remains high in both Taiwanese psychiatric
inpatients (Chiou et al. 2006, Lee et al. 2007) and outpatients
after hospital discharge (Thong et al. 2008). Similarly,
45% of 60 Turkish patients with schizophrenia (30 inpatients
and 30 stable outpatients) had a history of suicide attempts
(Evren & Evren 2004). Although the prevalence of psychiatric
disorders in the Netherlands was higher in urban than
rural areas (Peen et al. 2007), patients with schizophrenia in
rural areas of China were reported to have a greater risk of
suicide than those in urban areas (Phillips et al. 2004).
However, evidence indicates that patients in rural areas of
China (Phillips et al. 2004) and Taiwan (Huang et al. 2005)
are at higher risk than urban patients of inadequate health
care services. Similarly, patients with serious mental illness in
the USA who lived far from the health service system had a
greater risk of low health service use than those who lived
close to health services (McCarthy et al. 2007). Thus,
community-based health care providers need to pay more
attention to the issue of suicide attempts in rural patients with
schizophrenia.
Suicide attempts in patients with schizophrenia are significantly
associated with several factors, which may not be easy
for community-based health providers to evaluate. For
example, the major risk factors for suicide in Finland were
risk factors of schizophrenia-related disorders (Haukka et al.
2008), such as short duration of illness, depressive symptoms,
negative symptoms, active hallucinations and delusions
(Barak et al. 2008, Cozman et al. 2009, Hor & Taylor
2010), or higher rate of alcohol and drug abuse (Pinikahana
et al. 2003, Barak et al. 2008). Many community-based
health care providers lack the knowledge and experience to
handle encounters related to mental illness (Pollard 2007) or
deal with patients with addictions (Harrison 2007). The
effectiveness of community-based health care providers in
caring for Taiwanese patients with severe psychosis was
affected by lack of professional knowledge/skills and high
work burden from heavy case loads (Chang et al. 1995,
Huang et al. 2008).
Healthcare providers might evaluate suicide attempts in
patients with schizophrenia by asking simple questions
(Melrose 2009). For example, suicidal risk has been associated
with demographic characteristics such as younger age
and male gender (Limosin et al. 2007, Ran et al. 2007,
Haukka et al. 2008). Other well-known suicide predictors
อายุการใช้งานที่มีความชุกของโรคจิตเภทโดยประมาณจากการตรวจสอบระบบศึกษา 188 0Æ4% (บริษัทสห et al. 2005) ได้ในทำนองเดียวกัน ความชุกของโรคจิตเภทในไต้หวันประมาณมีข้อมูลจากชาติประกันสุขภาพ (นีนี่)0Æ44% (เจียน et al. 2004) โรคจิตเภทอิทธิพลไม่เฉพาะของประชาน อารมณ์ และสังคม (อเมริกันสมาคมจิตแพทย์ 2000) แต่นอกจากนี้การเกิดขึ้นของความพยายามฆ่าตัวตาย (เซียง et al. 2008 โรบินสัน et al. 2010)อัตราการฆ่าตัวตายอายุการใช้งานที่ประเมินจากความคิดของ 51ศึกษาในผู้ป่วยโรคจิตเภทจากยุโรป ภาคเหนืออเมริกาและเอเชียได้ประมาณ 5% (หอและเทย์เลอร์ 2010) ในไต้หวัน การตายฆ่าตัวตายของผู้ป่วยด้วยโรคจิตเภทในปี 2550 สูงกว่าสามเท่าได้ทั่วไปประชากร (แผนกสุขภาพไต้หวัน 2008) ในประเทศฟินแลนด์ประมาณ 30% ของผู้ป่วยโรคจิตเภท 18,199 ซ้ำพยายามฆ่าตัวตายระหว่าง 1996 (Haukka et al 2003ปี 2008) ผลเหล่านี้หลังบ่งชี้ว่า สุขภาพผู้ให้บริการดูแลผู้ป่วยโรคจิตเภทจำเป็นต้องทำเป็นมากระดับความสำคัญสูงในความเสี่ยงของการพยายามฆ่าตัวตายอยากฆ่าตัวตายความเสี่ยงยังคงสูงในไต้หวันทั้งจิตแพทย์inpatients (Chiou et al. 2006, Lee et al. 2007) และ outpatientsหลังจากปลดประจำโรงพยาบาล (ทองร้อยเอ็ด al. 2008) ในทำนองเดียวกัน45% 60 ตุรกีป่วยโรคจิตเภท (30 inpatientsและมั่นคง outpatients 30) มีประวัติศาสตร์ความพยายามฆ่าตัวตาย(Evren & Evren 2004) แม้ว่าความชุกของจิตแพทย์disorders in the Netherlands was higher in urban thanrural areas (Peen et al. 2007), patients with schizophrenia inrural areas of China were reported to have a greater risk ofsuicide than those in urban areas (Phillips et al. 2004).However, evidence indicates that patients in rural areas ofChina (Phillips et al. 2004) and Taiwan (Huang et al. 2005)are at higher risk than urban patients of inadequate healthcare services. Similarly, patients with serious mental illness inthe USA who lived far from the health service system had agreater risk of low health service use than those who livedclose to health services (McCarthy et al. 2007). Thus,community-based health care providers need to pay moreattention to the issue of suicide attempts in rural patients withschizophrenia.Suicide attempts in patients with schizophrenia are significantlyassociated with several factors, which may not be easyfor community-based health providers to evaluate. Forexample, the major risk factors for suicide in Finland wererisk factors of schizophrenia-related disorders (Haukka et al.2008), such as short duration of illness, depressive symptoms,negative symptoms, active hallucinations and delusions(Barak et al. 2008, Cozman et al. 2009, Hor & Taylor2010), or higher rate of alcohol and drug abuse (Pinikahanaet al. 2003, Barak et al. 2008). Many community-basedhealth care providers lack the knowledge and experience tohandle encounters related to mental illness (Pollard 2007) ordeal with patients with addictions (Harrison 2007). Theeffectiveness of community-based health care providers incaring for Taiwanese patients with severe psychosis wasaffected by lack of professional knowledge/skills and highwork burden from heavy case loads (Chang et al. 1995,Huang et al. 2008).Healthcare providers might evaluate suicide attempts inpatients with schizophrenia by asking simple questions(Melrose 2009). For example, suicidal risk has been associatedwith demographic characteristics such as younger ageand male gender (Limosin et al. 2007, Ran et al. 2007,Haukka et al. 2008). Other well-known suicide predictors
การแปล กรุณารอสักครู่..
