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近期精神病理学研究、有枪家庭与无枪家庭中的自杀意念与自杀未遂:全国共病调查再研究结果。

Recent psychopathology, suicidal thoughts and suicide attempts in households with and without firearms: findings from the National Comorbidity Study Replication.

机构信息

Harvard School of Public Health, Boston, Massachusetts 02115, USA.

出版信息

Inj Prev. 2009 Jun;15(3):183-7. doi: 10.1136/ip.2008.021352.

Abstract

OBJECTIVE

To assess the relationship between firearm ownership and possible psychiatric confounders of the firearm-suicide relationship.

METHODS

Multivariate logistic regression was used to estimate the association between living in a home with firearms and 12-month occurrence of major Diagnostic and statistical manual of mental disorders (DSM)-IV disorders and suicidal behaviour among respondents to the National Comorbidity Survey Replication, a household survey of 9282 adults aged 18+. Analyses controlled for sociodemographic characteristics including age, sex, race/ethnicity, educational attainment and poverty.

RESULTS

Approximately one in three Americans reported living in a home with firearms. People living in a home with firearms were no more or less likely than people in homes without firearms to have recent (past year) anxiety disorders (OR = 1.0, 95% CI 0.8 to 1.2), mood disorders (OR = 0.9, 95% CI 0.7 to 1.1) or substance dependence and/or abuse (OR = 0.9, 95% CI 0.6 to 1.3). Past year suicidal ideation (OR = 0.8, 95% CI 0.5 to 1.3) and suicide planning (OR = 0.5, 95% CI 0.2 to 1.4) were also not associated with living in households with firearms. Having made a suicide attempt over the previous year was the only outcome more common among participants reporting that they currently lived in a home without [corrected] firearms.

CONCLUSIONS

The previously reported association between household firearm ownership and heightened risk of suicide is not explained by a higher risk of psychopathology among gun-owning families. As there are Americans with suicidal ideation and/or significant and recent psychiatric disorders currently living in homes with firearms, future work should focus on understanding the impediments to effectively communicating the suicide risk associated with household firearms.

摘要

目的

评估枪支拥有与枪支自杀关系中可能存在的精神错乱混杂因素之间的关系。

方法

使用多变量逻辑回归来估计在枪支拥有家庭中与 12 个月内发生的主要诊断和统计手册(DSM-IV)精神障碍以及受访者中的自杀行为之间的关联,全国共病调查再调查是一项针对 9282 名 18 岁以上成年人的家庭调查。分析控制了社会人口统计学特征,包括年龄、性别、种族/族裔、教育程度和贫困状况。

结果

大约三分之一的美国人报告说生活在一个有枪支的家庭中。生活在有枪支的家庭中的人与没有枪支的家庭中的人相比,最近(过去一年)患有焦虑症(OR=1.0,95%CI0.8 至 1.2)、心境障碍(OR=0.9,95%CI0.7 至 1.1)或物质依赖和/或滥用(OR=0.9,95%CI0.6 至 1.3)的可能性没有更高或更低。过去一年有自杀意念(OR=0.8,95%CI0.5 至 1.3)和自杀计划(OR=0.5,95%CI0.2 至 1.4)也与居住在有枪支的家庭无关。在过去一年中曾尝试自杀是唯一比报告当前居住在没有[更正]枪支的家庭中的参与者更常见的结果。

结论

先前报告的家庭枪支拥有与自杀风险增加之间的关联不能用枪支拥有家庭中精神病理学风险增加来解释。由于目前有患有自杀意念和/或严重且近期精神障碍的美国人生活在有枪支的家庭中,未来的工作应重点关注理解有效传达与家庭枪支相关的自杀风险的障碍。

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