ImportanceAccording to the World Health Organization, more than 700 000 individuals worldwide die by suicide each year. Medical conditions likely increase the risk of suicide.ObjectiveTo (1) provide age- and sex-specific pairwise estimates of the risk of suicide across a comprehensive range of medical conditions, (2) investigate whether there is a dose-response–like relationship at play (ie, the higher the disability burden due to medical morbidity, the higher the risk of suicide), and (3) determine if the risk of suicide with medical conditions is particularly pronounced among those who had mental disorder preceding the medical conditions.Design, Setting, and ParticipantsThis cohort study was an observational study of population-based data for all individuals living in Denmark at some point between 2000 and 2020. The data analysis took place from September 2023 to May 2024.ExposuresThirty-one specific medical conditions as well as prior mental disorder.Main Outcomes and MeasuresThe main outcome was suicide. Associations between the 31 specific medical conditions, nested within 9 categories, and suicide were examined via Poisson regression, yielding incidence rate ratios (IRRs). Subsequent analyses included an interaction term to assess whether a previous hospital-treated mental disorder modified the associations. Finally, the association between the disability burden of medical conditions and suicide was examined for those with and without prior mental disorder, respectively.ResultsA total of 6 635 857 individuals (3 337 613 females and 3 298 244 males) were included in the analyses of the associations between medical conditions and suicide. Except for endocrine disorders, all categories of medical conditions were associated with a statistically significant increased risk of suicide (which was most pronounced for gastrointestinal conditions [IRR, 1.7; 95% CI,1.5-1.8], cancer [IRR, 1.5; 95% CI, 1.4-1.6], and hematological conditions [IRR, 1.5; 95% CI, 1.3-1.6]). Interaction between mental disorder and individual medical conditions did not seem to play a major role for suicide risk. For those without but not for those with mental disorder, there was a dose-response–like relationship between the disability burden of medical conditions and suicide.Conclusions and RelevanceMedical conditions are generally associated with increased risk of suicide in a dose-response–like manner. Individuals with hospital-treated mental disorder appear to be at such elevated risk of suicide that additional disability associated with medical conditions has little impact in this regard.

中文翻译：

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各种医疗状况下的自杀风险以及既往精神障碍的作用


重要性据世界卫生组织称，全世界每年有超过 70 万人死于自杀。医疗状况可能会增加自杀风险。 目标 (1) 提供针对各种医疗状况的特定年龄和性别的自杀风险的成对估计，(2) 调查是否存在类似剂量反应的关系设计、设置和参与者这项队列研究是对 2000 年至 2020 年期间某个时间点居住在丹麦的所有个人进行的基于人口的数据的观察性研究。数据分析发生于 2023 年 9 月至 2024 年 5 月。暴露了 31 种特定的医疗状况作为既往精神障碍。 主要结果和措施 主要结果是自杀。通过泊松回归检验了 9 类 31 种特定医疗状况与自杀之间的关联，得出发病率比 (IRR)。随后的分析包括一个交互项，以评估先前在医院治疗的精神障碍是否改变了这些关联。最后，分别对有和没有精神障碍的人进行了医疗条件造成的残疾负担与自杀之间的关联。 结果 共有 6 635 857 人（3 337 613 名女性和 3 298 244 名男性）纳入分析医疗状况与自杀之间的关联。 除内分泌失调外，所有类别的医疗状况均与统计上显着增加的自杀风险相关（其中胃肠道疾病 [IRR，1.7；95% CI，1.5-1.8]、癌症 [IRR，1.5；95%] 最为明显） CI，1.4-1.6]和血液学状况[IRR，1.5；95% CI，1.3-1.6]）。精神障碍和个人健康状况之间的相互作用似乎并未对自杀风险发挥主要作用。对于那些没有精神障碍但不患有精神障碍的人来说，医疗状况的残疾负担与自杀之间存在类似剂量反应的关系。结论和相关性医疗状况通常以类似剂量反应的方式与自杀风险增加相关。 。接受医院治疗的精神障碍患者的自杀风险似乎很高，因此与医疗状况相关的额外残疾在这方面几乎没有影响。