Joe Sean, Baser Raymond E, Breeden Gregory, Neighbors Harold W, Jackson James S
University of Michigan, Ann Arbor 48109, USA.
JAMA. 2006 Nov 1;296(17):2112-23. doi: 10.1001/jama.296.17.2112.
CONTEXT: Lack of data on the lifetime prevalence and age at onset of suicide ideation, plans, and attempts among blacks in the United States limits the creation and evaluation of interventions to reduce suicide among black Americans. OBJECTIVE: To examine the prevalence and correlates of suicide ideation, planning, and attempts across 2 ethnic classifications of blacks in a nationally representative sample. DESIGN, SETTING, AND PARTICIPANTS: Data are from the National Survey of American Life, a national household probability sample of 5181 black respondents aged 18 years and older, conducted between February 2001 and June 2003, using a slightly modified adaptation of the World Health Organization World Mental Health version of the Composite International Diagnostic Interview. Bivariate and survival analyses were used to delineate patterns and correlates of nonfatal suicidal behavior. MAIN OUTCOME MEASURES: Self-reports of lifetime suicide ideation, planning, and attempts. RESULTS: Survey respondents, categorized as African Americans and Caribbean Americans, reported lifetime prevalence of 11.7% for suicide ideation and 4.1% for attempts. Among the respondents who reported ideation, 34.6% transitioned to making a plan and only 21% made an unplanned attempt. Among 4 ethnic-sex groups, the 7.5% lifetime prevalence for attempts among Caribbean black men was the highest among black Americans. The greatest risk of progressing to suicide planning or attempt among ideators occurred within the first year after ideation onset. Blacks at higher risk for suicide attempts were in younger birth cohorts, less educated, Midwest residents, and had 1 or more Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders. CONCLUSIONS: This study documents the burden of nonfatal suicidality among US blacks, notably Caribbean black men, and individuals making planned attempts. Advancing research on the transition from suicide planning to attempt is vital to the efficacy of health care professionals' ability to screen blacks at risk for suicide.
背景：美国缺乏关于黑人自杀意念、计划和未遂的终生患病率及发病年龄的数据，这限制了减少美国黑人自杀的干预措施的制定和评估。 目的：在全国代表性样本中，研究两种黑人种族分类中自杀意念、计划和未遂的患病率及其相关因素。 设计、地点和参与者：数据来自美国生活全国调查，这是一项对5181名18岁及以上黑人受访者的全国家庭概率抽样调查，于2001年2月至2003年6月进行，采用了世界卫生组织复合国际诊断访谈的世界心理健康版本的略微修改版。采用双变量和生存分析来描述非致命自杀行为的模式和相关因素。 主要结局指标：自杀意念、计划和未遂的自我报告。 结果：被分类为非裔美国人和加勒比裔美国人的调查受访者报告，自杀意念的终生患病率为11.7%，未遂患病率为4.1%。在报告有自杀意念的受访者中，34.6%转变为制定计划，只有21%进行了无计划的尝试。在4个种族-性别组中，加勒比黑人男性7.5%的终生未遂患病率在美国黑人中最高。有自杀意念者发展为自杀计划或未遂的最大风险发生在自杀意念出现后的第一年内。自杀未遂风险较高的黑人出生队列较年轻、受教育程度较低、居住在中西部，并且患有1种或更多种《精神疾病诊断与统计手册》第四版中的疾病。 结论：本研究记录了美国黑人，尤其是加勒比黑人男性和有计划自杀未遂者的非致命自杀负担。推进从自杀计划到自杀未遂转变的研究对于医疗保健专业人员筛查有自杀风险黑人的能力的有效性至关重要。
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