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老年人的自杀意念:与心理健康问题和服务利用的关系。

Suicide ideation in older adults: relationship to mental health problems and service use.

机构信息

Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada M5T 3M7.

出版信息

Gerontologist. 2010 Dec;50(6):785-97. doi: 10.1093/geront/gnq048. Epub 2010 Jun 21.

Abstract

PURPOSE

to assess the prevalence of suicide ideation among community-dwelling older adults and the relationship between suicide ideation, major psychiatric disorder, and mental health service use.

DESIGN AND METHODS

we use data from the Canadian Community Health Survey 1.2: Mental Health and Well-being (CCHS 1.2). We estimate the prevalence of suicide ideation and the prevalence of major psychiatric disorder and service use among ideators versus nonideators. In multivariate models, we consider the sociodemographic, social, and mental health correlates of suicide ideation and mental health care use.

RESULTS

in our sample, more than 2% of older adults reported suicide ideation in the past year and more than two thirds of these respondents did not meet the criteria for any of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders assessed in the CCHS 1.2. In multivariate models, being male, younger, or widowed, reporting lower social support and higher psychological distress increased the likelihood of suicide ideation. More than 50% of the respondents who reported suicidal thoughts did not access any type of mental health care use.

IMPLICATIONS

although suicide ideation is associated with depression and anxiety disorders, many older adults with suicidal thoughts do not meet the criteria for these clinical disorders. The low prevalence of service use among older adults with suicide ideation suggests the need for further inquiry into the factors associated with discussing mental health concerns with health care providers, particularly among older adults who do not meet the criteria for clinical disorder.

摘要

目的

评估社区居住的老年人中存在自杀意念的流行情况,以及自杀意念与主要精神障碍和精神卫生服务利用之间的关系。

设计和方法

我们使用加拿大社区健康调查 1.2:心理健康和幸福感(CCHS 1.2)的数据。我们估计存在自杀意念的老年人的比例,以及意念者与非意念者之间的主要精神障碍和服务利用的比例。在多变量模型中,我们考虑了自杀意念和精神卫生保健利用的社会人口统计学、社会和心理健康相关因素。

结果

在我们的样本中,超过 2%的老年人在过去一年中报告有自杀意念,超过三分之二的这些受访者不符合 CCHS 1.2 评估的《精神障碍诊断与统计手册》第四版中任何一种疾病的标准。在多变量模型中,男性、年龄较小或丧偶、报告较低的社会支持和较高的心理困扰增加了自杀意念的可能性。报告有自杀想法的受访者中,超过 50%没有利用任何类型的精神卫生保健。

意义

尽管自杀意念与抑郁和焦虑障碍有关,但许多有自杀意念的老年人不符合这些临床障碍的标准。有自杀意念的老年人中服务利用的低比例表明需要进一步研究与卫生保健提供者讨论心理健康问题的相关因素,特别是在不符合临床障碍标准的老年人中。

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