Danel T, Vilain J, Roelandt J L, Salleron J, Vaiva G, Amariei A, Plancke L, Duhamel A
Fédération régionale de recherche en santé mentale du Nord pas de calais (F2RSM).
Encephale. 2010;36(3 Suppl):39-57. doi: 10.1016/S0013-7006(10)70017-8.
The Santé Mentale en Population Générale Survey (Mental Health in General Population Survey (MHGP)) is a multicentre international research and action project initiated by the World Health Organisation Collaboration Centre for research and training in mental health. Its aims are to assess the prevalence of the major mental health disorders in the general adult population and from this to record perceptions associated with "mental illness", "madness" and "depression" together with different means of assistance and specialist or lay care. In this work we present the analysis of data on risks of suicide and past history of suicide attempts in the Nord pas de Calais region. We present the qualitative features of these phenomena and correlations with socio-economic, cultural and psychopathological factors, which are discussed in terms of both protective and vulnerability factors. Risk of suicide is present in 15% of the Nord pas de Calais population and is divided into 10.44% slight risk, 2.37% moderate risk and 2.2% high risk. A comparison with data from the MHGP survey in other regions reveals the high risk of suicide in the NPDC region. A risk of suicide is present is 13% of the population in other SMPG survey regions, broken down into 9.1% low risk, 2.1% medium risk and 1.7% high risk. Compared to the 2.2% high risk figure for NPDC, the population in this category is 21% larger. In terms of risk and protective factors, a bivariate analysis of socio-economic and cultural factors confirms the classical risk factors of sex, marital, occupational and educational status and income. The odds-ratio for these socio-economic and cultural factors can be calculated from logistic regression and the protective factors ranked in decreasing order from religion (Muslim versus other religions), martial status (marked versus separated), age (over 58 years old), occupational status (working or retired versus unemployed), income (more than 1300 euros versus less than 840 euros), sex (men versus women) and immigration. For mental illness, the bivariate analysis confirms that the risk of suicide is significantly higher regardless of the mental disorder in question. Logistic regression categorises the mental illnesses as risk factors in the following order: depression, psychotic disorders, anxiety, alcohol abuse disorders, other drugs and insomnia. Suicide attempts have been made by 9.7% of the study population. This figure should be compared with the 8% of the study population in other regions in the survey and represents 29% more attempts. For the risk and protective factors the results of the bivariate analysis of socio-economic on cultural and psychopathological factors are superimposeable on those found for risk of suicide. The ranking of protective factors obtained from logistic regression places age in first position followed in decreasing order by religion, martial status, income, employment status and finally sex and immigration. The same ranking of mental illnesses by logistic regression places depression as the greatest risk factor followed by anxiety, psychotic disorders, alcohol abuse disorders, drugs and insomnia.
“普通人群心理健康调查”(MHGP)是由世界卫生组织心理健康研究与培训合作中心发起的一项多中心国际研究与行动项目。其目的是评估普通成年人群中主要心理健康障碍的患病率,并据此记录与“精神疾病”“疯狂”和“抑郁症”相关的认知,以及不同的援助方式和专业或非专业护理情况。在这项工作中,我们展示了对加来海峡省地区自杀风险和既往自杀未遂史数据的分析。我们呈现了这些现象的定性特征以及与社会经济、文化和心理病理因素的相关性,并从保护因素和脆弱性因素两方面进行了讨论。加来海峡省15%的人口存在自杀风险,其中低风险为10.44%,中度风险为2.37%,高风险为2.2%。与其他地区MHGP调查数据相比,加来海峡省地区自杀风险较高。在其他SMPG调查地区,13%的人口存在自杀风险,其中低风险为9.1%,中度风险为2.1%,高风险为1.7%。与加来海峡省2.2%的高风险数据相比,这一类别中的人口多出21%。在风险和保护因素方面,对社会经济和文化因素的双变量分析证实了性别、婚姻、职业、教育状况和收入等经典风险因素。这些社会经济和文化因素的优势比可通过逻辑回归计算得出,保护因素按宗教(穆斯林与其他宗教)、婚姻状况(已婚与分居)、年龄(58岁以上)、职业状况(在职或退休与失业)、收入(超过1300欧元与低于840欧元)、性别(男性与女性)和移民的顺序递减排列。对于精神疾病,双变量分析证实,无论所讨论的精神障碍如何,自杀风险都显著更高。逻辑回归将精神疾病按风险因素的顺序分类如下:抑郁症、精神障碍、焦虑症、酒精滥用障碍、其他药物和失眠症。研究人群中有9.7%的人曾有过自杀未遂行为。这一数字应与调查中其他地区研究人群的8%进行比较,表明自杀未遂行为多出29%。对于风险和保护因素,社会经济、文化和心理病理因素的双变量分析结果与自杀风险的分析结果相似。逻辑回归得出的保护因素排名中,年龄位居首位,其次按宗教、婚姻状况、收入、就业状况递减排列,最后是性别和移民。逻辑回归对精神疾病的相同排名中,抑郁症是最大的风险因素,其次是焦虑症、精神障碍、酒精滥用障碍、药物和失眠症。