Department of Psychiatry, The Institute for Juvenile Research, University of Illinois at Chicago, Chicago, Illinois.
Depress Anxiety. 2013 Oct;30(10):991-6. doi: 10.1002/da.22143. Epub 2013 Aug 15.
To examine the role of depression and exposure to peer or family suicide and their interaction as risk factors for adolescent suicide attempts.
The study used the public-use data set of the National Longitudinal Study of Adolescent Health (Add Health), which is a nationally representative stratified sample of U.S. high school students. Sample size was 4,719. Analyses predicted suicide attempts from preexisting depression and exposure to suicide of a friend or family member, controlling for previous suicide attempts, exposure, and depression.
The greatest risk for future suicide attempts (relative risk = 3.3), was attributable to an attempt in the preceding year, controlling for preexisting and current depression and exposure. There was a main effect of exposure with the next highest relative risk of 3.2. A similar risk ratio, 3.2, was found for the difference between no depression and current severe depression, controlling for past depression and attempts. There was no evidence of an interaction between exposure to a peer or family member suicide attempt and depression. Supplementary analyses found that exposure to a friend or family member suicide attempt or completed suicide each added significantly to risk for adolescents regardless of depression levels.
Exposure to suicidal behavior in a friend or family member poses risk equivalent to the risk posed by becoming severely depressed. Attending to such risks could benefit clinical practice with adolescence and public health suicide prevention efforts.
探讨抑郁、同伴或家人自杀暴露及其相互作用作为青少年自杀未遂的危险因素的作用。
本研究使用了美国青少年纵向健康研究（Add Health）的公共数据集，该数据集是美国高中学生的全国代表性分层样本。样本量为 4719 人。分析预测了自杀未遂与先前存在的抑郁和自杀暴露于朋友或家庭成员之间的关系，同时控制了先前的自杀尝试、暴露和抑郁情况。
与先前存在的和当前的抑郁以及暴露情况相比，在前一年发生自杀未遂的风险最高（相对风险=3.3）。暴露有一个主要作用，其次是下一个最高的相对风险为 3.2。在控制过去的抑郁和尝试的情况下，无抑郁和当前严重抑郁之间的差异也有类似的风险比 3.2。没有发现抑郁和暴露于同伴或家人自杀尝试之间的相互作用的证据。补充分析发现，暴露于朋友或家人的自杀尝试或自杀完成都对青少年的风险有显著的增加，而与抑郁程度无关。
暴露于朋友或家人的自杀行为会带来与严重抑郁相同的风险。关注这些风险可能会有益于青少年的临床实践和公共卫生预防自杀工作。
