Kang Hee-Ju, Stewart Robert, Jeong Bo-Ok, Kim Seon-Young, Bae Kyung-Yeol, Kim Sung-Wan, Kim Jae-Min, Shin Il-Seon, Yoon Jin-Sang
Department of Psychiatry & Depression Clinical Research Center, Chonnam National University Medical School, Gwangju, South Korea.
Int Psychogeriatr. 2014 Jan;26(1):59-67. doi: 10.1017/S1041610213001634. Epub 2013 Sep 25.
This study aimed to assess the prevalence, incidence, and persistence of suicidal ideation (SI), and to investigate the psychosocial factors associated with these.
A total of 1,204 community dwelling elderly adults aged 65 years or older were evaluated at baseline, 909 (75%) of whom were followed two years later. The presence of SI was identified using the questions from the community version of the Geriatric Mental State (GMS) diagnostic schedule (GMS B3) at both baseline and follow-up interviews. Baseline measures included demographic status, years of education, rural/urban residence, accommodation, past and current occupation, monthly income, marital status, stressful life events, social support deficits, number of physical illnesses, severity of pain, physical activity, disability, depressive symptoms, anxiety, insomnia, cognitive function, alcohol consumption, and smoking.
Baseline SI prevalence, follow-up incidence (SI rate at follow-up of 805 elderly subjects who did not have SI at baseline), and persistence (SI rate at follow-up of 104 elderly subjects who had SI at baseline) were 11.5%, 9.6%, and 36.5%, respectively. Baseline SI was independently associated with no current employment, lower monthly income, stressful life events, more severe pain, presence of disability, depressive symptoms, and smoking. Incident SI was independently predicted by baseline unmarried status, social support deficit, severe pain, presence of depressive symptoms, and smoking. Persistent SI was independently predicted by baseline stressful life events and depressive symptoms.
Depressive symptoms were independently associated with prevalent, incident, and persistent SI, but other predictors varied according to incidence and persistence outcomes.
本研究旨在评估自杀意念(SI)的患病率、发病率和持续存在情况,并调查与之相关的社会心理因素。
共有1204名65岁及以上的社区居住老年人在基线时接受评估,其中909人(75%)在两年后接受随访。在基线和随访访谈中,使用老年精神状态(GMS)诊断量表社区版(GMS B3)中的问题来确定是否存在自杀意念。基线测量包括人口统计学状况、受教育年限、农村/城市居住情况、居住方式、过去和当前职业、月收入、婚姻状况、生活应激事件、社会支持不足、身体疾病数量、疼痛严重程度、身体活动、残疾情况、抑郁症状、焦虑、失眠、认知功能、饮酒和吸烟情况。
基线时自杀意念患病率、随访发病率(基线时无自杀意念的805名老年人随访时的自杀意念发生率)和持续存在率(基线时有自杀意念的104名老年人随访时的自杀意念发生率)分别为11.5%、9.6%和36.5%。基线时的自杀意念与当前无工作、月收入较低、生活应激事件、疼痛更严重、存在残疾、抑郁症状和吸烟独立相关。新发自杀意念由基线时未婚状态、社会支持不足、严重疼痛、存在抑郁症状和吸烟独立预测。持续性自杀意念由基线时的生活应激事件和抑郁症状独立预测。
抑郁症状与自杀意念的普遍存在、新发和持续存在独立相关,但其他预测因素因发病率和持续存在情况的结果而异。