University of California, San Diego, San Diego, CA 92103-8231, United States.
J Affect Disord. 2012 Feb;136(3):993-9. doi: 10.1016/j.jad.2011.06.044. Epub 2011 Jul 23.
Estimates of the prevalence of lifetime suicidal ideation and attempt, and risks for new-onset suicidality, among HIV-infected (HIV+) individuals are not widely available in the era of modern combined antiretroviral treatment (cART).
Participants (n=1560) were evaluated with a comprehensive battery of tests that included the depression and substance use modules of the Composite International Diagnostic Interview (CIDI) and the Beck Depression Inventory-II (BDI-II) as part of a large prospective cohort study at six U.S. academic medical centers. Participants with possible lifetime depression (n=981) were classified into five categories: 1) no thoughts of death or suicide (n=352); 2) thoughts of death (n=224); 3) thoughts of suicide (n=99); 4) made a suicide plan (n=102); and 5) attempted suicide (n=204).
Twenty-six percent (405/1560) of participants reported lifetime suicidal ideation and 13% (204/1560) reported lifetime suicide attempt. Participants who reported suicidal thoughts or plans, or attempted suicide, reported higher scores on the BDI-II (p<0.0001), and higher rates of current major depressive disorder (p=0.01), than those who did not. Attempters reported higher rates of lifetime substance abuse (p=0.02) and current use of psychotropic medications (p=0.01) than non-attempters.
Study assessments focused on lifetime, rather than current, suicide. Data was not collected on the timing of ideation or attempt, frequency, or nature of suicide attempt.
High rates of lifetime suicidal ideation and attempt, and the relationship of past report with current depressed mood, suggest that mood disruption is still prevalent in HIV. Findings emphasize the importance of properly diagnosing and treating psychiatric comorbidities among HIV persons in the cART era.
在现代联合抗逆转录病毒治疗（cART）时代，HIV 感染者（HIV+）一生中出现自杀意念和尝试的估计以及新出现自杀风险的估计并不广泛。
参与者（n=1560）接受了一系列综合测试，其中包括复合国际诊断访谈（CIDI）的抑郁和物质使用模块以及贝克抑郁量表第二版（BDI-II），作为六个美国学术医疗中心的大型前瞻性队列研究的一部分。有潜在自杀意念的参与者（n=981）分为五类：1）无死亡或自杀念头（n=352）；2）有死亡念头（n=224）；3）有自杀念头（n=99）；4）制定自杀计划（n=102）；5）自杀未遂（n=204）。
26%（405/1560）的参与者报告有过自杀意念，13%（204/1560）报告有过自杀尝试。报告有自杀想法或计划或自杀未遂的参与者，BDI-II 评分较高（p<0.0001），当前患有重度抑郁症的比例较高（p=0.01），而没有自杀想法或计划的参与者则没有。尝试者报告有更高的终生物质滥用率（p=0.02）和当前使用精神药物的比例（p=0.01）高于非尝试者。
研究评估侧重于终生，而不是当前，自杀。没有收集关于意念或尝试的时间、频率或自杀尝试的性质的数据。
高比例的终生自杀意念和尝试，以及过去报告与当前抑郁情绪的关系，表明情绪障碍在 HIV 中仍然普遍存在。这些发现强调了在 cART 时代正确诊断和治疗 HIV 人群中精神共病的重要性。
