Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
BMC Psychiatry. 2012 Sep 19;12:149. doi: 10.1186/1471-244X-12-149.
Since the 2010 earthquake in Haiti, there has been increased international attention to mental health needs throughout the country. The present study represents one of the first epidemiologic studies of depression symptomatology, suicidal ideation, and associated factors in Haiti's Central Plateau.
We conducted a cross-sectional, zone-stratified household survey of 408 adults in Haiti's Central Plateau. Depression symptomatology was assessed with a culturally-adapted Kreyòl version of the Beck Depression Inventory (BDI). Multivariable linear and logistic regression models were built using backward elimination, with the outcomes being continuous BDI scores and endorsing suicidal ideation, respectively.
The mean BDI score was 20.4 (95% confidence interval [CI]: 19.3-21.5), and 6.13% (N = 25) of participants endorsed current suicidal ideation. Factors associated with BDI scores were: continuous age (adjusted beta [aβ]: 0.14, CI: 0.06-0.22), female gender (aβ: 2.1, CI: 0.18-4.0), suicidal ideation (aβ: 11.1, CI: 7.3-14.9), death in family (aβ: 2.7, CI: 0.57-4.9), and prior life-threatening illness (aβ: 2.6, CI: 0.77-4.5). Education was a risk factor for depression among women but not among men, and employment was a risk factor for both genders. Factors associated with endorsing suicidal ideation were: BDI score (ten point change) (adjusted odds ratio [aOR]: 2.5, CI: 1.7-3.6), lack of care if sick (aOR: 5.5, CI: 1.1-28.6), alcohol use (aOR: 3.3, CI: 1.3-8.2), and ever having been to a Vodou priest (aOR: 3.2, CI: 1.1-9.5).
A large proportion of Haiti's Central Plateau may be experiencing high levels of depression symptomatology and/or current suicidal ideation. Screening could be conducted in biomedical, religious, and Vodou healing contexts. For prevention, poverty reduction and improved healthcare access are key elements. For treatment, general psychiatric services, psychosocial services for the medically ill and their families, and substance abuse interventions should be explored. Paradoxical associations related to education and employment require further exploration.
自 2010 年海地地震以来，国际社会对该国的精神健康需求日益关注。本研究代表了海地中央高原地区首次对抑郁症状、自杀意念及其相关因素进行的流行病学研究之一。
我们对海地中央高原地区的 408 名成年人进行了横断面、分区分层家庭调查。使用经过文化适应的克里奥尔语版贝克抑郁量表（BDI）评估抑郁症状。使用向后消除法建立多变量线性和逻辑回归模型，结果分别为连续 BDI 评分和自杀意念。
平均 BDI 评分为 20.4（95%置信区间[CI]：19.3-21.5），6.13%（N=25）的参与者目前有自杀意念。与 BDI 评分相关的因素包括：连续年龄（调整后的β[β]：0.14，CI：0.06-0.22）、女性（β：2.1，CI：0.18-4.0）、自杀意念（β：11.1，CI：7.3-14.9）、家庭死亡（β：2.7，CI：0.57-4.9）和既往有生命威胁的疾病（β：2.6，CI：0.77-4.5）。教育是女性抑郁的危险因素，但不是男性的危险因素，而就业是两性的危险因素。与自杀意念相关的因素包括：BDI 评分（十分点变化）（调整后的优势比[aOR]：2.5，CI：1.7-3.6）、生病时无人照顾（aOR：5.5，CI：1.1-28.6）、饮酒（aOR：3.3，CI：1.3-8.2）和曾经去过伏都教牧师（aOR：3.2，CI：1.1-9.5）。
海地中央高原地区很大一部分人可能正在经历高度的抑郁症状和/或目前的自杀意念。可以在生物医学、宗教和伏都教治疗背景下进行筛查。为了预防，减少贫困和改善医疗保健机会是关键要素。对于治疗，应探讨一般精神科服务、患有医学疾病及其家属的心理社会服务以及药物滥用干预措施。与教育和就业相关的矛盾关联需要进一步探讨。
