青少年自殺之流行病學研究──以台灣北部某縣市為例

The Epidemiology of Suicide among Adolescents and Young Adults in Northern Taiwan

目的：對有自殺求助（含主動及被動）或行動的青少年：(1)估計自殺率（含意念、企圖、死亡）。(2)分析自殺行動的危險因子。(3)分析有自殺行動者致死的影響因素。方法：對台灣北部某縣市2010年的自殺通報檔及死亡檔作次級資料分析。結果：共742個案。整體自殺率(10-5)為94.2（95%信賴區間：87.7-101.2）。意念率、企圖率及死亡率分別為10.9、79.1、4.2。女性意念率及企圖率高於男性，死亡率男性高於女性。隨著年齡增加，三種率均增加。自殺原因以情感∕人際問題最多(61.6%)。多變量結果顯示，年齡為自殺行動的影響因素。自殺行動者中，自殺方式為致死的重要因素。吊勒∕窒息的死亡勝算比(27.83)最高，固體或液體物質∕切穿工具的死亡勝算比(0.02)較低。結論：台灣北部某縣市青少年自殺意念率、企圖率女性高於男性，死亡率是男性高於女性。隨著年齡增加，三種自殺率均增加。自殺行動者中，自殺方式為致死的重要因素。

Purposes: Estimate the rate of suicide (including ideation, attempts, and completions) among adolescents and young adults (10-24 years old) in northern Taiwan in 2010. (2) Determine the factors affecting those who did these acts. (3) Determine the factors affecting lethality. Methods: Perform secondary data analysis utilizing the suicide reporting system and the death registry. Results: A total of 742 cases were identified. The total suicide rate was 94.2 per 100 000 (95% confidence interval: 87.7-101.2). The rates of suicidal ideation, attempted suicide, and completed suicide were 10.9, 79.1, and 4.2, respectively. The rates of suicidal ideation and attempted suicide in females were higher than those in males; however, the rate of completed suicide in males was higher than that in females. The rates of all three types of suicide increased consistently with age. Affection/inter-personal relationship was the main reason for suicide (61.6%). On multivariate analysis, age was the most important factor determining completed suicide. Among those who completed suicide, the means was the most important factor in determining lethality. Hanging/suffocating had the highest odds ratio (27.83) for lethality. Ingesting solid/liquid material or cutting was less fatal (0.02). Conclusions: Among 10-24 year olds in northern Taiwan, the rates of suicidal ideation and attempted suicide were higher in females than in males. The rate of completed suicide was higher in males than in females. Among those who completed suicide, the means was the most important factor in determining lethality.