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首页> 外文期刊>Occupational and environmental medicine >Are all-cause and diagnosis-specific sickness absence, and sick-leave duration risk indicators for suicidal behaviour? A nationwide register-based cohort study of 4.9 million inhabitants of Sweden
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Are all-cause and diagnosis-specific sickness absence, and sick-leave duration risk indicators for suicidal behaviour? A nationwide register-based cohort study of 4.9 million inhabitants of Sweden

机译：是否存在因全因和诊断而引起的疾病以及具有自杀行为的病假持续时间危险指标？对瑞典490万居民进行的基于全国登记的队列研究

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Objectives: Recent studies have found an increased risk of suicide in people on sickness absence, but less is known about to what extent diagnosis-specific sickness absence is a risk indicator for suicidal behaviour. This study aimed to examine all-cause and diagnosis-specific sickness absence and sick-leave duration as risk indicators for suicide attempt and suicide. Methods: This is a population-based prospective cohort study. All non-retired adults (n=4 923 404) who lived in Sweden as on 31 December 2004 were followed-up for 6 years regarding suicide attempt and suicide (2005-2010). HRs and 95% CIs for suicidal behaviour were calculated, using people with no sick-leave spells in 2005 as reference. Results: In analyses adjusted for sociodemographic factors and previous mental healthcare, suicide attempt and current antidepressants prescription, sickness absence predicted suicide attempt (HR 2.37; 95% CI 2.25 to 2.50 for women; HR 2.69; 95% CI 2.53 to 2.86 for men) and suicide (HR 1.91; 95% CI 1.60 to 2.29 for women; HR 1.92; 95% CI 1.71 to 2.14 for men), particularly mental sickness absence (range of HR: 2.74-3.64). The risks were also increased for somatic sickness absence, for example, musculoskeletal and digestive diseases and injury/poisoning (range of HR: 1.57-3.77). Moreover, the risks increased with sick-leave duration. Conclusions: Sickness absence was a clear risk indicator for suicidal behaviour, irrespective of sick-leave diagnoses, among women and men. Awareness of such risks is recommended when monitoring sickness certification. Further studies are warranted in order to gain more detailed knowledge on these associations.
机译：目的：最近的研究发现，由于缺乏疾病而使人们自杀的风险增加，但对因诊断而特定的疾病缺乏在多大程度上是自杀行为的危险指标知之甚少。这项研究旨在检查全因和特定诊断的疾病缺勤和病假持续时间，作为自杀未遂和自杀的风险指标。方法：这是一项基于人群的前瞻性队列研究。截至2004年12月31日，在瑞典居住的所有未退休成年人（n = 4 923 404）均接受了6年的自杀未遂和自杀随访（2005-2010年）。以2005年没有病假的人为参考，计算了自杀行为的HR和95％CI。结果：在根据社会人口统计学因素和先前的精神保健，自杀未遂和当前抗抑郁药处方进行调整的分析中，疾病缺席预计会发生自杀未遂（HR 2.37;女性95％CI 2.25至2.50; HR 2.69; 95％CI 2.53至2.86）和自杀（HR 1.91;女性95％CI 1.60至2.29; HR 1.92; 95％CI 1.71至2.14），尤其是精神病患者（HR范围：2.74-3.64）。缺乏躯体疾病的风险也增加了，例如，肌肉骨骼和消化系统疾病以及伤害/中毒（HR范围：1.57-3.77）。此外，随着病假时间的延长，风险增加。结论：不论是否有病假诊断，患病都是男女自杀行为的明确危险指标。建议在监视疾病证明时意识到此类风险。为了获得有关这些关联的更详细的知识，有必要进行进一步的研究。

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