Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Psychol Med. 2014 Mar;44(4):779-88. doi: 10.1017/S0033291713001207. Epub 2013 Jun 6.
Cardiovascular fitness influences many aspects of brain function. However, the relationship between cardiovascular fitness and suicidal behaviour is unknown. Therefore, we aimed to determine whether cardiovascular fitness at age 18 years is associated with future risk of suicide attempt/death.
We performed a population-based Swedish longitudinal cohort study of male conscripts with no previous or ongoing mental illness (n = 1,136,527). The conscription examination, which took place during 1968-2005, included the cycle ergonometric test and tests of cognitive performance. Future risk of suicide attempt/death over a 5- to 42-year follow-up period was calculated with Cox proportional hazards models controlling for several confounders including familial factors.
At least one suicide attempt was recorded for 12,563 men. Death by suicide without a prior attempt was recorded in 4814 additional individuals. In fully adjusted models low cardiovascular fitness was associated with increased risk for future attempt/death by suicide [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.64-1.94]. The HR changed only marginally after exclusion of persons who received in-patient care for depression (HR 1.76, 95% CI 1.61-1.94). Poor performance on both the cardiovascular fitness and cognitive tests was associated with a fivefold increased risk of suicide attempt or suicide death (HR 5.46, 95% CI 4.78-6.24).
Lower cardiovascular fitness at age 18 years was, after adjustment for a number of potential confounders, associated with an increased risk of attempt/death by suicide in adulthood. It remains to be clarified whether interventions designed to improve fitness in teens can influence the risk of suicidal behaviour later in life.
心血管健康状况会影响大脑功能的多个方面。然而，心血管健康状况与自杀行为之间的关系尚不清楚。因此，我们旨在确定 18 岁时的心血管健康状况是否与未来自杀未遂/死亡的风险相关。
我们进行了一项基于人群的瑞典纵向队列研究，纳入了没有既往或正在进行的精神疾病的男性应征者（n=1,136,527）。应征检查于 1968-2005 年进行，包括循环测功试验和认知表现测试。通过 Cox 比例风险模型计算未来 5 至 42 年随访期间自杀未遂/死亡的风险，模型中控制了包括家族因素在内的多个混杂因素。
至少有 12,563 名男性记录到了一次自杀未遂。另外还有 4814 名个体死于自杀，但生前没有尝试自杀。在完全调整的模型中，低心血管健康状况与未来自杀未遂/死亡的风险增加相关[风险比 (HR) 1.79，95%置信区间 (CI) 1.64-1.94]。排除因抑郁接受住院治疗的人群后，HR 仅略有变化（HR 1.76，95% CI 1.61-1.94）。心血管健康状况和认知测试的表现均较差与自杀未遂或自杀死亡的风险增加五倍相关（HR 5.46，95% CI 4.78-6.24）。
在调整了一些潜在混杂因素后，18 岁时较低的心血管健康状况与成年后自杀未遂/死亡的风险增加相关。尚不清楚旨在改善青少年健康状况的干预措施是否会影响以后生活中的自杀行为风险。
