Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon.
Psychol Med. 2012 Oct;42(10):2109-18. doi: 10.1017/S0033291712000268. Epub 2012 Feb 28.
Suicide rates increase following periods of war; however, the mechanism through which this occurs is not known. The aim of this paper is to shed some light on the associations of war exposure, mental disorders, and subsequent suicidal behavior.
A national sample of Lebanese adults was administered the Composite International Diagnostic Interview to collect data on lifetime prevalence and age of onset of suicide ideation, plan, and attempt, and mental disorders, in addition to information about exposure to stressors associated with the 1975-1989 Lebanon war.
The onset of suicide ideation, plan, and attempt was associated with female gender, younger age, post-war period, major depression, impulse-control disorders, and social phobia. The effect of post-war period on each type of suicide outcome was largely explained by the post-war onset of mental disorders. Finally, the conjunction of having a prior impulse-control disorder and either being a civilian in a terror region or witnessing war-related stressors was associated with especially high risk of suicide attempt.
The association of war with increased risk of suicidality appears to be partially explained by the emergence of mental disorders in the context of war. Exposure to war may exacerbate disinhibition among those who have prior impulse-control disorders, thus magnifying the association of mental disorders with suicidality.
战争时期过后自杀率会上升；然而，其发生的机制尚不清楚。本文旨在探讨战争暴露、精神障碍与随后自杀行为之间的关联。
对黎巴嫩的成年人进行了一项全国性的抽样调查，采用复合国际诊断访谈收集关于自杀意念、计划和尝试的终生患病率和发病年龄以及精神障碍的数据，以及与 1975-1989 年黎巴嫩战争相关的应激源暴露的信息。
自杀意念、计划和尝试的发生与女性性别、年龄较小、战后时期、重性抑郁症、冲动控制障碍和社交恐惧症有关。战后时期对每种自杀结局的影响在很大程度上可以用战后精神障碍的发生来解释。最后，有冲动控制障碍病史的人如果是战区的平民或目睹了与战争相关的应激源，则自杀尝试的风险特别高。
战争与自杀风险增加的关联似乎部分可以通过精神障碍在战争背景下的出现来解释。战争的暴露可能会加剧那些有先前冲动控制障碍的人的抑制能力丧失，从而放大精神障碍与自杀之间的关联。
