在情感障碍高发地区,饮用水中的锂含量可预测自杀未遂与自杀身亡的比例:生态研究的启示

Vilma Jakiene , Nijole Raskauskiene , Rima Naginiene , Narseta Mickuviene
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引用次数: 0

摘要

导言锂具有明显的抗自杀作用:它能显著降低情感障碍患者过高的总死亡率。方法在立陶宛 53 个城市收集公共饮用水样本,为期两个月。结果饮用水中的锂能非线性地预测自杀未遂与自杀身亡的比率(A/S),呈 U 型曲线。情感障碍发病率和自杀标准死亡率与锂含量的关系曲线显示,自杀曲线明显下降,情感障碍曲线呈反方向。高锂暴露组(> 7 µg/L,N = 26)的 A/S 比率多变量回归模型表明,在锂暴露量高于中位数且情感障碍发病率高的城市中,锂水平可解释 A/S 比率变异的 54.3%。结论研究结果提供了确凿证据,表明在情感障碍发病率较高的城市,公共饮用水中的锂含量越高,A/S 比值越高,原因是自杀未遂的人数不变,自杀致死的人数减少。最后,还需要进行队列研究、前瞻性研究或干预研究,以验证这些变量之间的因果反向关系,并推测这种关系的机制。
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Lithium levels in drinking water predicted the ratio of attempted to completed suicides in regions with high incidence of affective disorders: Insights from ecological study

Introduction

Lithium has demonstrated significant antisuicidal effects: it significantly reduces the high excess overall mortality of patients with affective disorders.

Methods

Public drinking water samples were collected in 53 Lithuanian municipalities during a two-month period. Linear models used lithium level in public drinking water as predictor and ratio of suicide attempts to suicide mortality as outcomes across the municipalities.

Results

Lithium in drinking water predicted the ratio of attempted to completed suicides (A/S) nonlinearly, described by a U-shaped curve. The curves for visualization of the association of incidence of affective disorders and suicide standard mortality rate with lithium level displayed significant suicide curve decrements and invers direction in affective disorders curve. Multivariate regression model for ratio A/S in high lithium exposure group (> 7 µg/L, N = 26) suggests that the lithium level can explain 54.3 % of variance of ratio A/S in municipalities with exposure of lithium above median and with high incidence of affective disorders.

Conclusions

The findings provide confirmatory evidence that in municipalities with high incidence of affective disorders higher lithium levels in the public drinking water are associated with higher ratio A/S due to an unchanging number of suicide attempts and due to decreasing suicide lethal outcomes.

Limitations

Nevertheless, the methods employed detected several factors with well-established associations with suicide. Finally, cohort, prospective or intervention studies are needed to verify the causal inverse relationship of these variables and to speculate the mechanism for this relationship.

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来源期刊
Journal of Affective Disorders Reports
Journal of Affective Disorders Reports Psychology-Clinical Psychology
CiteScore
3.80
自引率
0.00%
发文量
137
审稿时长
134 days
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