Jeon Hong Jin, Lee Christina, Fava Maurizio, Mischoulon David, Shim Eun-Jung, Heo Jung-Yoon, Choi Hong, Park Jae-Hyun
*Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; †Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, South Korea; ‡Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston; §Department of Psychology, Wellesley College, MA; ∥Department of Psychology, Pusan National University, South Korea; and ¶Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, South Korea.
J Nerv Ment Dis. 2014 Dec;202(12):870-6. doi: 10.1097/NMD.0000000000000217.
Although previous studies have suggested that childhood trauma and parental death are strongly associated with suicidality in adulthood, it is still unclear how these factors interact within the same population. A total of 1396 adults were recruited through nationwide multistage probability sampling in South Korea. Subjects were evaluated through face-to-face interviews using the Suicidality Module of the Mini-International Neuropsychiatric Interview and the Early Trauma Inventory Self Report-Short Form. Among the 1396 adults, the group that experienced both childhood trauma and parental death had the highest current suicidality risks (F = 12.16, p < 0.0001) and lifetime suicide attempt (χ2 = 35.81, p < 0.0001) compared with the other groups, which were only childhood trauma, only parental death, and neither. Multivariate logistic regression analyses revealed that middle-to-high current suicidality risk and lifetime suicide attempt were significantly associated with concurrent childhood trauma and parental death (odds ratio, 3.64; 95% confidence interval, 1.99-6.65) as well as with only childhood trauma (odds ratio, 1.95; 95% confidence interval, 1.33-2.87), after adjusting for age, sex, education, marital status, household monthly income, and living area. Emotional abuse was the only type of childhood trauma significantly associated with higher current suicidality scores in those who experienced childhood parental death than in those who did not (F = 3.26, p = 0.041). Current suicidality risk and lifetime suicide attempt are associated with experiencing both parental death and trauma, especially emotional abuse, in childhood, whereas experiencing only childhood parental death is associated with neither.
尽管先前的研究表明童年创伤和父母死亡与成年后的自杀倾向密切相关，但这些因素在同一人群中如何相互作用仍不清楚。通过韩国全国范围内的多阶段概率抽样招募了1396名成年人。使用迷你国际神经精神病学访谈的自杀倾向模块和早期创伤问卷自我报告简表，通过面对面访谈对受试者进行评估。在这1396名成年人中，与仅经历童年创伤、仅经历父母死亡以及两者都未经历的其他组相比，同时经历童年创伤和父母死亡的组当前的自杀风险最高（F = 12.16，p < 0.0001），且终身自杀未遂率最高（χ2 = 35.81，p < 0.0001）。多变量逻辑回归分析显示，在调整年龄、性别、教育程度、婚姻状况、家庭月收入和居住地区后，中到高的当前自杀风险和终身自杀未遂与童年创伤和父母死亡同时发生（优势比，3.64；95%置信区间，1.99 - 6.65）以及仅与童年创伤相关（优势比，1.95；95%置信区间，1.33 - 2.87）。在经历童年父母死亡的人群中，情感虐待是唯一一种与较高的当前自杀倾向得分显著相关的童年创伤类型，而在未经历童年父母死亡的人群中则不然（F = 3.26，p = 0.041）。当前的自杀风险和终身自杀未遂与童年时期经历父母死亡和创伤，尤其是情感虐待有关，而仅经历童年父母死亡则与两者均无关。
