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被动自杀意念:寻求老龄服务的老年人中风险的一个指标?

Passive Suicide Ideation: An Indicator of Risk Among Older Adults Seeking Aging Services?

作者信息

Van Orden Kimberly A, O'Riley Alisa A, Simning Adam, Podgorski Carol, Richardson Thomas M, Conwell Yeates

机构信息

Department of Psychiatry, University of Rochester Medical Center, New York.

出版信息

Gerontologist. 2015 Dec;55(6):972-80. doi: 10.1093/geront/gnu026. Epub 2014 Apr 8.

Abstract

OBJECTIVES

This study examines patterns of endorsements of active suicide ideation (SI), passive SI (synonymous with death ideation), and psychological distress (i.e., depressive and anxious symptomatology) in a sample of vulnerable older adults.

METHODS

Data were collected via in-home interviews with aging services care management clients aged 60 years and older (n = 377). The Paykel scale for suicide measured the most severe level of suicidality over the past year, and the ninth item of the Patient Health Questionnaire (PHQ-9) measured current passive/active SI. The remaining items from the PHQ (i.e., PHQ-8) and the Goldberg Anxiety scale measured distress.

RESULTS

Latent class analysis revealed a four-class model: a group with mild distress and no active SI, a group with high distress and no ideation, a group with mild distress and both passive and active SI, and a group with high distress and both passive and active SI.

DISCUSSION

Results indicate that passive SI rarely presents in vulnerable older adults in the absence of significant risk factors for suicide (i.e., psychological distress or active SI). Thus, the desire for death and the belief that life is not worth living do not appear to be normative in late life.

摘要

目的

本研究调查了一组弱势老年人中主动自杀意念(SI)、被动自杀意念(与死亡意念同义)以及心理困扰(即抑郁和焦虑症状)的认可模式。

方法

通过对60岁及以上的老年服务护理管理客户进行上门访谈收集数据(n = 377)。Paykel自杀量表测量过去一年中最严重的自杀倾向程度,患者健康问卷(PHQ - 9)的第九项测量当前的被动/主动自杀意念。PHQ的其余项目(即PHQ - 8)和戈德堡焦虑量表测量困扰程度。

结果

潜在类别分析揭示了一个四类模型:一类是轻度困扰且无主动自杀意念的群体,一类是高度困扰且无意念的群体,一类是轻度困扰且有被动和主动自杀意念的群体,以及一类是高度困扰且有被动和主动自杀意念的群体。

讨论

结果表明,在没有显著自杀风险因素(即心理困扰或主动自杀意念)的情况下,被动自杀意念在弱势老年人中很少出现。因此,对死亡的渴望和认为生命不值得活下去的信念在晚年似乎并不常见。

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