Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Awka, Nnewi, Nigeria.
Soc Psychiatry Psychiatr Epidemiol. 2011 Mar;46(3):173-80. doi: 10.1007/s00127-009-0178-2. Epub 2010 Feb 6.
Mental and substance use disorders are often associated with an elevated risk for suicidal behaviors. The role of the co-occurrence of multiple disorders in this association is still unclear.
The Nigerian Survey of Mental Health and Wellbeing is a community survey of mental and substance use disorders as well as of suicidal outcomes. Face-to-face assessment was conducted using the World Health Organization's Composite International Diagnostic Interview, version 3. A total of 6,752 adults, aged 18 years and over, were interviewed.
Persons with lifetime suicide attempt were more likely than those without attempt to have experienced lifetime DSM-IV disorders. Lifetime attempters were also more likely to have comorbid conditions. Compared with only 0.4% of persons with no history of lifetime attempts, over 11% of persons with lifetime attempt had three or more co-occurring disorders. Multivariate analysis controlling for the effects of comorbid conditions suggests that while mood disorder is independently associated with suicidal outcomes, comorbidity partly explains the association of anxiety disorders and almost fully accounts for the association of substance use disorders with suicidal outcomes.
Comorbidity is an important factor in the association of mental and substance use disorders with suicidal behavior.
精神和物质使用障碍通常与自杀行为的风险增加有关。多种障碍同时存在对这种关联的作用仍不清楚。
尼日利亚精神健康和幸福感调查是一项对精神和物质使用障碍以及自杀结果的社区调查。使用世界卫生组织的复合国际诊断访谈，第 3 版进行面对面评估。共对 6752 名 18 岁及以上的成年人进行了访谈。
有过终生自杀企图的人与没有自杀企图的人相比，更有可能经历过 DSM-IV 障碍。终生企图自杀者也更有可能同时患有多种疾病。与没有终生企图自杀史的人相比，仅有 0.4%的人一生中尝试过三次或更多次共病。在控制共病影响的多变量分析中，虽然心境障碍与自杀结果独立相关，但共病部分解释了焦虑障碍的相关性，几乎完全解释了物质使用障碍与自杀结果的相关性。
共病是精神和物质使用障碍与自杀行为关联的一个重要因素。
