Goodwin Renee, Olfson Mark
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA.
Psychol Med. 2002 Oct;32(7):1293-9. doi: 10.1017/s0033291702006323.
To determine the relationship between self-perceived health and suicidal ideation among patients in general internal medicine practice settings.
A representative sample of 4007 patients was assessed for current suicidal ideation, self-perception of health, current medical disorders and current mental disorders (major depression, generalized anxiety disorder, panic attacks and alcohol use disorder) with the PRIME-MD Patient Health Questionnaire.
Patients with self-perception of poor health, compared with those who reported more favourable health perception, were significantly more likely to report current suicidal ideation (35.2% v. 8.3%; chi2 = 97.4, df = 1, P < 0.0001). Multivariate logistic regression analyses revealed that the perception of poor health was associated with a significantly increased risk of suicidal ideation (OR = 3.1, CI 1.9, 5.0), even after adjusting for sociodemographic characteristics, mental disorders and common physical illnesses.
Self-perception of poor health is associated with a significantly increased risk of suicidal ideation among general medical patients, even in the absence of common mental and physical disorders. These findings add to a growing literature on the importance of self-perceived health in the treatment and outcomes of mental and physical well-being by documenting self-perceived poor health as a risk factor for suicidal ideation in medical patients.
确定普通内科门诊患者自我感知健康与自杀意念之间的关系。
采用PRIME-MD患者健康问卷，对4007例具有代表性的患者样本进行评估，以了解其当前的自杀意念、健康自我感知、当前的躯体疾病和精神疾病（重度抑郁症、广泛性焦虑症、惊恐发作和酒精使用障碍）情况。
自我感知健康状况较差的患者与那些报告健康感知较好的患者相比，报告当前有自杀意念的可能性显著更高（35.2%对8.3%；χ² = 97.4，自由度 = 1，P < 0.0001）。多因素逻辑回归分析显示，即使在调整了社会人口学特征、精神疾病和常见躯体疾病后，健康状况较差的感知仍与自杀意念风险显著增加相关（比值比 = 3.1，可信区间1.9，5.0）。
即使在没有常见精神和躯体疾病的情况下，普通内科患者自我感知健康状况较差也与自杀意念风险显著增加相关。这些发现通过将自我感知健康状况较差记录为内科患者自杀意念的一个风险因素，为关于自我感知健康在身心健康治疗和结局中的重要性的文献增添了内容。
