Kessler Ronald C, Berglund Patricia, Borges Guilherme, Nock Matthew, Wang Philip S
Department of Health Care Policy, Harvard Medical School, Boston, Mass 02115, USA.
JAMA. 2005 May 25;293(20):2487-95. doi: 10.1001/jama.293.20.2487.
Little is known about trends in suicidal ideation, plans, gestures, or attempts or about their treatment. Such data are needed to guide and evaluate policies to reduce suicide-related behaviors.
To analyze nationally representative trend data on suicidal ideation, plans, gestures, attempts, and their treatment.
DESIGN, SETTING, AND PARTICIPANTS: Data came from the 1990-1992 National Comorbidity Survey and the 2001-2003 National Comorbidity Survey Replication. These surveys asked identical questions to 9708 people aged 18 to 54 years about the past year's occurrence of suicidal ideation, plans, gestures, attempts, and treatment. Trends were evaluated by using pooled logistic regression analysis. Face-to-face interviews were administered in the homes of respondents, who were nationally representative samples of US English-speaking residents.
Self-reports about suicide-related behaviors and treatment in the year before interview.
No significant changes occurred between 1990-1992 and 2001-2003 in suicidal ideation (2.8% vs 3.3%; P = .43), plans (0.7% vs 1.0%; P = .15), gestures (0.3% vs 0.2%; P = .24), or attempts (0.4%-0.6%; P = .45), whereas conditional prevalence of plans among ideators increased significantly (from 19.6% to 28.6%; P = .04), and conditional prevalence of gestures among planners decreased significantly (from 21.4% to 6.4%; P = .003). Treatment increased dramatically among ideators who made a gesture (40.3% vs 92.8%) and among ideators who made an attempt (49.6% vs 79.0%).
Despite a dramatic increase in treatment, no significant decrease occurred in suicidal thoughts, plans, gestures, or attempts in the United States during the 1990s. Continued efforts are needed to increase outreach to untreated individuals with suicidal ideation before the occurrence of attempts and to improve treatment effectiveness for such cases.
关于自杀意念、计划、行为或未遂情况的趋势以及它们的治疗方法，人们了解甚少。需要此类数据来指导和评估减少自杀相关行为的政策。
分析有关自杀意念、计划、行为、未遂情况及其治疗的全国代表性趋势数据。
设计、背景和参与者：数据来自1990 - 1992年全国共病调查以及2001 - 2003年全国共病调查复制研究。这些调查向9708名年龄在18至54岁之间的人询问了过去一年中自杀意念、计划、行为、未遂情况以及治疗情况的相同问题。通过汇总逻辑回归分析评估趋势。在受访者家中进行面对面访谈，受访者是美国说英语居民的全国代表性样本。
访谈前一年关于自杀相关行为和治疗的自我报告。
1990 - 1992年与2001 - 2003年期间，自杀意念（2.8%对3.3%；P = 0.43）、计划（0.7%对1.0%；P = 0.15）、行为（0.3%对0.2%；P = 0.24）或未遂情况（0.4% - 0.6%；P = 0.45）均无显著变化，而有自杀意念者中计划的条件患病率显著增加（从19.6%增至28.6%；P = 0.04），有计划者中行为的条件患病率显著下降（从21.4%降至6.4%；P = 0.003）。有自杀行为者和有自杀未遂者中接受治疗的比例大幅增加（分别从40.3%增至92.8%以及从49.6%增至79.0%）。
尽管治疗有显著增加，但20世纪90年代美国自杀念头、计划、行为或未遂情况并未显著减少。仍需继续努力，在自杀未遂发生之前，扩大对有自杀意念但未接受治疗者的干预范围，并提高此类病例的治疗效果。
