Armstrong Gregory, Jorm Anthony F, Samson Luke, Joubert Lynette, Singh Shalini, Kermode Michelle
Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Level 4, Alan Gilbert Building, 161 Barry St, Carlton, VIC, 3010, Australia,
Soc Psychiatry Psychiatr Epidemiol. 2014 Sep;49(9):1367-77. doi: 10.1007/s00127-014-0899-8. Epub 2014 Jun 8.
Suicide is major public health problem in India. The objective of the analyses presented in this paper is to examine depressive and anxiety symptoms and socio-demographic indicators as correlates of suicidal ideation and attempts among people who inject drugs (PWID), a high-risk group for suicide.
We analysed data collected in April-May of 2012 from a community-based sample of 420 PWID in Delhi using time location sampling. Self-report symptom scales were used to measure the severity of symptoms of depression (PHQ-9) and anxiety (GAD-2) within the preceding 2 weeks. We assessed the presence of suicidal thoughts within the past 12 months.
Depressive and anxiety symptoms were associated with suicidal ideation, as were a range of social stressors including poor physical health, length of injecting drug use, housing insecurity, and experiences of violence and sexual abuse. However, depressive and anxiety symptoms were not associated with suicide attempts. Factors associated with suicide attempts among ideators were housing insecurity and relational dynamics including a poor relationship with family and, interestingly, being married.
Suicide prevention interventions among this population should address not only individual mental health and addiction support needs but also the overwhelmingly poor psychosocial circumstances of this group.
自杀是印度一个主要的公共卫生问题。本文所呈现分析的目的是,在注射吸毒者(PWID)这一自杀高危群体中,研究抑郁和焦虑症状以及社会人口学指标与自杀意念及自杀未遂之间的关联。
我们采用时间地点抽样法,对2012年4月至5月从德里420名社区注射吸毒者样本中收集的数据进行了分析。使用自我报告症状量表来测量前两周内抑郁症状(PHQ - 9)和焦虑症状(GAD - 2)的严重程度。我们评估了过去12个月内自杀想法的存在情况。
抑郁和焦虑症状与自杀意念相关,一系列社会压力源也与之相关,包括身体健康状况差、注射吸毒时间长短、住房无保障以及暴力和性虐待经历。然而,抑郁和焦虑症状与自杀未遂无关。有自杀意念者中与自杀未遂相关的因素是住房无保障以及人际关系动态,包括与家人关系不佳,有趣的是,还包括已婚状况。
针对这一人群的自杀预防干预措施不仅应满足个人心理健康和成瘾支持需求,还应解决该群体极其恶劣的心理社会环境问题。