Kim Yeowon A, Bogner Hillary R, Brown Gregory K, Gallo Joseph J
University of Pennsylvania, Philadelphia 19104, USA.
Int J Psychiatry Med. 2006;36(2):183-98. doi: 10.2190/3QXD-UR0H-K8FH-2CU8.
To determine the prevalence of wishes to die and the medical correlates of wishes to die among primary care patients aged 65 years and older.
Three-hundred and fifty-five adults with and without significant depressive symptoms who were screened in primary care offices and invited to participate completed a baseline in-home assessment. Participants were interviewed using standardized measures of medical conditions, functional status, and psychological status. Thoughts of death and wishes to die were assessed with standard questions from the Composite International Diagnostic Interview (CIDI) Depression Section.
The weighted point prevalence of thoughts of death was 9.7% and 6.1% for the wish to die. Several medical conditions were associated with a wish to die, for example myocardial infarction (MI). In multivariate models that adjusted for potentially influential characteristics, the association between a history of MI and the wish to die remained statistically significant (odds ratio (OR) = 3.32, 95% confidence interval (CI) (1.26, 8.75).
Thoughts of death and a wish to die are common in older primary care patients and were more likely among persons with chronic medical conditions. Persons with a history of myocardial infarction may be particularly vulnerable to a wish to die.
确定65岁及以上初级保健患者中想死的意愿的患病率以及想死意愿的医学相关因素。
在初级保健诊所接受筛查并受邀参与的355名有或无明显抑郁症状的成年人完成了一次基线家庭评估。使用关于医疗状况、功能状态和心理状态的标准化测量方法对参与者进行访谈。使用综合国际诊断访谈（CIDI）抑郁部分的标准问题评估死亡念头和想死的意愿。
死亡念头的加权点患病率为9.7%，想死意愿的加权点患病率为6.1%。几种医疗状况与想死意愿相关，例如心肌梗死（MI）。在对潜在影响因素进行调整的多变量模型中，心肌梗死病史与想死意愿之间的关联仍具有统计学意义（优势比（OR）=3.32，95%置信区间（CI）（1.26，8.75））。
死亡念头和想死意愿在老年初级保健患者中很常见，并且在患有慢性疾病的人群中更有可能出现。有心肌梗死病史的人可能特别容易产生想死的意愿。
