Department of Community Health Sciences, Faculty of Medicine, Université de Sherbrooke, Longueuil, Quebec, Canada.
Int Psychogeriatr. 2013 Mar;25(3):374-81. doi: 10.1017/S1041610212001895. Epub 2012 Dec 5.
To ascertain gender-specific determinants of antidepressant and mental health (MH) service use associated with suicidal ideation.
Data used in this study came from the ESA (Enquête sur la Santé des Aînés) survey carried out in 2005-2008 on a large sample of community-dwelling older adults (n = 2,004). Multivariate logistic regression analyses were carried out.
The two-year prevalence of suicidal ideation was 8.4% and 20.3% had persistent suicidal thoughts at one-year follow-up. In males, the prevalence of antidepressant and MH service use in respondents with suicidal ideation reached 32.2% and 48.9%, respectively. In females, the corresponding rates were 42.6% and 65.6%. Males were less likely to consult MH services than females when their MH was judged poorly. Male respondents with higher income and education were less likely to use antidepressant and MH services. However, males using benzodiazepines were more likely than females to be dispensed an antidepressant. Among respondents with suicidal ideation, gender was not associated with service use. Younger age, however, was associated with antidepressant use.
Increased promotion campaigns sensitizing men to the prodromal symptoms of depression and the need to foster access to MH care when the disorder is manageable may be needed.
确定与自杀意念相关的、具有性别特异性的抗抑郁药和精神健康(MH)服务使用的决定因素。
本研究使用的数据来自于 2005-2008 年对大量社区居住的老年人(n=2004)进行的 ESA(老年人健康调查)调查。进行了多变量逻辑回归分析。
自杀意念的两年患病率为 8.4%,一年随访时有 20.3%的人持续有自杀念头。在男性中,有自杀意念的受访者中抗抑郁药和 MH 服务的使用患病率分别达到 32.2%和 48.9%。在女性中,相应的比率为 42.6%和 65.6%。当 MH 被判断为不佳时,男性比女性更不可能咨询 MH 服务。收入和教育程度较高的男性使用抗抑郁药和 MH 服务的可能性较小。但是,使用苯二氮䓬类药物的男性比女性更有可能被开出抗抑郁药。在有自杀意念的受访者中,性别与服务使用无关。但是,年龄较小与使用抗抑郁药有关。
可能需要增加宣传活动,使男性对抑郁的前驱症状敏感,并在疾病可控制时促进获得 MH 护理。