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臺灣自殺防治策略與現況 PowerPoint PPT Presentation


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臺灣自殺防治策略與現況. 廖士程 臺灣自殺防治學會秘書長 衛生署委辦全國自殺防治中心兼代執行長 台大醫院精神醫學部主治醫師. 101 年 3 月精神及心理衛生人員訓練班. 報告大綱. 世界各國及台灣自殺問題現況 自殺的危險因子 當代世界自殺防治主流思潮 國家自殺防治策略 老年人口之自殺防治 成效與挑戰. 臺灣自殺防治策略與現況. 世界各國及台灣自殺問題現況. 自殺為多重因素造成之悲劇結果. 自殺行為絕非單一因素可造成 自殺的成因複雜而多樣,往往包含了精神疾病、心理學因素、社會經濟因素、家庭因素、人際關係問題、以及生物性體質因素等。

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臺灣自殺防治策略與現況

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    • Hawton K., BMJ 1998;317:156-157.


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http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/print.html

2002

2009

2011


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Age and sex specified suicide mortality rates in taiwan 1994 to 2009

Age and sex specified suicide mortality rates in Taiwan (1994 to 2009)

Males have twice and more risk of suicide death than females.

There is no sex difference in the gradient of suicide risk across age strata.

Male

Female

Male

Female


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1.9093

2.99(31.42%)(31.47%)


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The charcoal-burning epidemic has altered the geography of suicide in Taiwan.

Chang SS et al: PLoS Med 2010;7: e1000212


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Lin et al. BMC Public Health 2010, 10:480


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Hawton K&von Heeringen K: Lancet 2009;373:137281.

  • Distal

    • (Genetic loading)

    • (Personality characteristics:impulsivity, aggression)

    • (Restricted fetal growth and peri-natal circumstances)

    • (Early traumatic life events)

    • (Serotonin and hypothalamic-pituitary dysfunction)

  • Proximal

    • (Psychiatric disorder)

    • (Physical disorder)

    • (Psychosocial crisis)

    • (Availability of means)

    • (Exposure to models)


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  • /

  • Malone & Mann, 2000


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    • Chen V et al. Soc Psychiatry Psychiatr Epidemiol 2011:1-5.

    • Chang SS et al. Health Place 2011, 17(2):641-650.

    • Yang AC et al.J Affect Disord. 2011;129(1-3):275-81.

    • Cheng ATet al. Int J Epidemiol. 2007;36(6):1229-34.


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    • 97%

    • 50%

    • 45%

    • 30%

    • 13%

    • Cheng AT: Arch Gen Psychiatry. 1995;52:594-603.


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    Br J Psychiatry 1997; 170: 205-28.


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    Caine ED, Knox KL, Conwell Y. Public health and population approaches for suicide prevention. In: Cohen N, Galea S, editors. Population mental health: Evidence, policy, and public health practice First ed. New York: Routledge; 2011. p. 303-38.


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    :


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    Suicide is usually the tragic end point of various possible pathways, influenced by mental ill health and psychological, socioeconomic, familial, interpersonal, and genetic factors.

    Indicative

    Selective

    Universal


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    to

    /

    Mann JJ et al: JAMA. 2005; 294: 2064- 2075.


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    Mann JJ et al: JAMA. 2005; 294: 2064- 2075.


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    Caine ED, Knox KL, Conwell Y. Public health and population approaches for suicide prevention. In: Cohen N, Galea S, editors. Population mental health: Evidence, policy, and public health practice First ed. New York: Routledge; 2011. p. 303-38.


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      • (universal)

      • (selective)

      • (indicative)


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    Meta-analysis of effect of psychosocial interventions on completed suicide

    Crawfold MJ et al. Br J Psychiatry 2007;190:11-17.


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    24

    24

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    ()


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    • 201017,6999,1711.92

    • (63.5%)

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    • 20062008

      • 48.9%

      • 44.4%


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    Prevalence, severity, and help seeking behaviors of major depression in Taiwan, China, Japan, and U.S. in WMH-CIDI studies

    Liao SC, Chen WJ, Lee MB et al., submitted paper, 2011


    Healthcare utilisation by males and females within 12 months prior to suicide

    Healthcare utilisation by males and females within 12 months prior to suicide

    Psychiatric disorders were diagnosed in 48% of females and 30.2% of males, but major depression was diagnosed in only 17.8% of females and 7.4% of males.

    Chang CM et al. Br J Psychiatry 2009;195:459-60.


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    Cheng AT et al., J Clin Psychiatry 2007;68:862-6.


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    The economic tsunami, unemployment rate, and suicide

    Bankruptcy of Lehman Brothers Holdings Inc.


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    (JAMA)

    • 3-4

    • 6

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    JAMA.2006;295(24):2952.


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    103


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