All-cause and suicide mortality after first psychiatric admission in adolescents and young adults: A longitudinal follow-up study

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2024-09-02 DOI:10.1016/j.jad.2024.08.221
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Abstract

Background

This study investigated all-cause and suicide mortality rates in adolescents and young adults following an initial psychiatric admission to elucidate the long-term outcomes for this vulnerable group by focusing on the risks associated with various psychiatric diagnostic categories.

Methods

This study involved 9762 adolescents and young adults discharged from their first psychiatric admission and matched 1:1 with 9762 individuals discharged following a diagnosis of appendicitis on the basis of birth year and sex by using Taiwan's National Health Insurance Research Database. Both stratified (model 1) and standard (model 2) Cox regression analyses were conducted to assess variations in all-cause and suicide mortality between the groups.

Results

Over the 15-year follow-up period, the adolescents and young adults discharged from their first psychiatric admission exhibited an approximately 3-fold increased risk of death from any cause (hazard ratio [HR]: 2.97 in model 1, 2.83 in model 2) and an approximately ten times higher risk of suicide (11.13 in model 1, 9.23 in model 2) compared with those discharged with a diagnosis of appendicitis. Those discharged with alcohol use disorder or major depressive disorder exhibited higher hazard ratios for both all-cause and suicide compared with the reference group.

Conclusions

The findings reveal a considerable risk of all-cause and suicide mortality in adolescents and young adults following discharge from their first psychiatric admission. These results highlight an urgent need for tailored interventions and continued support for this demographic.

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青少年首次入住精神病院后的全因死亡率和自杀死亡率:纵向跟踪研究。
背景:本研究调查了首次入住精神病院的青少年和年轻人的全因死亡率和自杀死亡率,通过关注与不同精神病诊断类别相关的风险,阐明这一弱势群体的长期结局:本研究利用台湾国民健康保险研究数据库,将9762名首次入住精神病院后出院的青少年和年轻人与9762名诊断为阑尾炎后出院的人按出生年份和性别进行1:1配对。研究人员进行了分层(模型1)和标准(模型2)Cox回归分析,以评估各组间全因死亡率和自杀死亡率的差异:在长达 15 年的随访期内,与诊断为阑尾炎的出院者相比,首次入住精神病院的青少年和年轻成人因各种原因死亡的风险增加了约 3 倍(模型 1 中的危险比 [HR]:2.97,模型 2 中的 2.83),自杀风险增加了约 10 倍(模型 1 中的 11.13,模型 2 中的 9.23)。与参照组相比,因酒精使用障碍或重度抑郁障碍而出院者的全因风险比和自杀风险比均较高:研究结果表明,青少年和年轻人在首次入住精神病院出院后,全因死亡和自杀的风险相当高。这些结果突出表明,迫切需要为这一人群提供量身定制的干预措施和持续支持。
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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