Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA.
Compr Psychiatry. 2011 May-Jun;52(3):238-46. doi: 10.1016/j.comppsych.2010.07.003. Epub 2010 Sep 9.
Suicide, as the 11th leading cause of death in America, is a significant public health concern. Previous studies have shown that drug users are a population at especially high risk for suicidal ideation (SI). Although most people who think about killing themselves do not ultimately commit suicide, identifying those at risk for such thoughts is important.
In this analysis, data from a sample of 462 cocaine-using women (87% African American) recruited using street outreach methods for a National Institute on Drug Abuse-funded study were examined to identify risk factors for lifetime SI. Sociodemographic factors, adverse childhood experiences, sexual behaviors, psychiatric comorbidities, and drug abuse and dependence were examined as potential risk factors using both bivariate and logistic regression analysis.
Fifty percent of the sample met at least one criterion for lifetime SI, and 32% of the sample reported a lifetime suicide attempt. In the final logistic regression model, childhood physical abuse, childhood sexual abuse, rape after the age of 15 years, posttraumatic stress disorder, and number of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, depression criteria met emerged as significant independent predictors of lifetime SI.
These findings identify important risk factors for SI among female substance abusers in community settings.
自杀是美国第 11 大死因,是一个严重的公共卫生问题。先前的研究表明,吸毒者自杀意念(SI)的风险特别高。尽管大多数有自杀念头的人最终不会自杀,但识别有这种想法的人很重要。
在这项分析中,对 462 名使用可卡因的女性(87%为非裔美国人)的样本数据进行了检查,这些女性是通过街头外联方法招募来参加国家药物滥用研究所资助的一项研究的,以确定终生 SI 的风险因素。使用双变量和逻辑回归分析,检查了社会人口因素、不良的童年经历、性行为、精神共病和药物滥用和依赖,以确定其是否为潜在风险因素。
样本中有 50%的人至少符合终生 SI 的一个标准,有 32%的人报告有过终生自杀企图。在最终的逻辑回归模型中,童年期身体虐待、童年期性虐待、15 岁以后的强奸、创伤后应激障碍以及符合《精神障碍诊断与统计手册》第四版的抑郁标准被确定为终生 SI 的重要独立预测因素。
这些发现确定了社区环境中女性药物滥用者 SI 的重要风险因素。