Goodwin Renee D, Roy-Byrne Peter
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
Depress Anxiety. 2006;23(3):124-32. doi: 10.1002/da.20151.
Our objective was to determine the association between panic attacks (PAs) and panic disorder (PD), and suicidal ideation (SI) and suicide attempts (SAs) in a nationally representative sample of adults in the community. Data were drawn from the National Comorbidity Survey (n=5,877), a representative household sample of adults ages 15-54 in the United States. Multiple logistic regression analyses were used to examine the relationship between current and lifetime PA and PD and SI and SA, adjusting for differences in demographic characteristics, comorbid mental disorders (major depression, alcohol dependence, and substance dependence), childhood trauma (physical and sexual abuse), and number of lifetime mental disorders. Past-year and lifetime PA and PD were associated with increased SI (both past year and lifetime), and persisted after adjusting for comorbidity and early trauma. Associations between PA and SA were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with lifetime SA, but these associations were no longer statistically significant after adjusting for comorbidity. Past-year and lifetime PD were associated with past-year SA, and this association persisted after adjusting for demographics, comorbidity, and number of lifetime mental disorders. These findings are consistent with previous results, and further help to clarify the relationships between panic and suicide behavior by identifying potential methodological reasons for inconsistencies in results from previous studies.
我们的目标是在全国具有代表性的社区成年人样本中,确定惊恐发作(PA)与惊恐障碍(PD)、自杀意念(SI)和自杀未遂(SA)之间的关联。数据取自全国共病调查(n = 5877),这是美国一个具有代表性的15 - 54岁成年人家庭样本。采用多重逻辑回归分析来检验当前和终生PA与PD以及SI与SA之间的关系,并对人口统计学特征、共病精神障碍(重度抑郁症、酒精依赖和物质依赖)、童年创伤(身体和性虐待)以及终生精神障碍的数量差异进行了调整。过去一年和终生的PA与PD均与SI增加相关(过去一年和终生),在对共病和早期创伤进行调整后这种关联依然存在。在对共病进行调整后,PA与SA之间的关联不再具有统计学意义。过去一年和终生的PD与终生SA相关,但在对共病进行调整后,这些关联不再具有统计学意义。过去一年和终生的PD与过去一年的SA相关,在对人口统计学、共病和终生精神障碍数量进行调整后,这种关联依然存在。这些发现与之前的结果一致,并通过识别先前研究结果不一致的潜在方法学原因,进一步有助于阐明惊恐与自杀行为之间的关系。