有严重自杀想法的中老年成年人：谁制定了自杀计划和非致命性自杀企图？
Middle-aged and older adults who had serious suicidal thoughts: who made suicide plans and nonfatal suicide attempts?
机构信息
School of Social Work,The University of Texas at Austin,1925 San Jacinto Blvd,D3500,Austin,Texas 78712,USA.
出版信息
Int Psychogeriatr. 2015 Mar;27(3):491-500. doi: 10.1017/S1041610214002464. Epub 2014 Nov 21.
BACKGROUND
High suicide rates in late middle-aged and older adults are significant public health problems. Although suicide risk and protective factors are well established, more research is needed about suicide planners and attempters. Using multi-year, national epidemiologic survey data, this study identified correlates of making suicide plans and nonfatal suicide attempts among U.S. adults aged 50+ years.
METHODS
Data are from the 2008 to 2012 U.S. National Survey on Drug Use and Health (NSDUH). Descriptive statistics were used to examine sample characteristics by past-year serious suicidal thoughts, suicide plans, and suicide attempts. Binary logistic regression analyses were used to examine potential correlates (sociodemographic factors, health status, religiosity, psychiatric and substance use disorders (SUDs), and mental health and substance abuse treatment use) of suicide plans and suicide attempts among those who reported serious suicidal thoughts.
RESULTS
Of the 2.5% of the study population that had serious suicidal thoughts (n = 804), 28% made suicide plans and 11.5% attempted suicide. Although 42% of those with serious suicidal thoughts had major depressive episode (MDE), MDE was not significantly associated with suicide plans or attempts in multivariate models. Being employed decreased the odds of making suicide plans, while mental health service use was associated with increased odds of suicide plans. SUDs increased the odds of suicide attempts.
CONCLUSIONS
It is important to screen middle-aged and older adults for severe mental and SUDs and suicidal thoughts and to target interventions for likely planners and attempters.
背景
中老年人群的自杀率较高，是一个严重的公共卫生问题。尽管自杀风险和保护因素已得到充分证实，但仍需要更多研究来了解自杀策划者和尝试者。本研究利用多年的全国性流行病学调查数据，确定了美国 50 岁及以上成年人制定自杀计划和非致命性自杀尝试的相关因素。
方法
数据来自 2008 年至 2012 年美国国家药物使用与健康调查（NSDUH）。采用描述性统计方法，根据过去一年有过严重自杀念头、有自杀计划和自杀尝试的情况，对样本特征进行了检查。采用二元逻辑回归分析，对报告有严重自杀念头的人群中，与自杀计划和自杀尝试相关的潜在因素（社会人口统计学因素、健康状况、宗教信仰、精神和物质使用障碍（SUDs）以及心理健康和物质滥用治疗的使用）进行了检验。
结果
在有严重自杀念头的研究人群中（n=804），有 2.5%的人制定了自杀计划，11.5%的人尝试了自杀。尽管有 42%的有严重自杀念头的人患有重性抑郁障碍（MDE），但在多变量模型中，MDE 与自杀计划或尝试并无显著关联。有工作的人自杀计划的可能性降低，而心理健康服务的使用与自杀计划的可能性增加有关。SUDs 增加了自杀尝试的可能性。
结论
对中年和老年人进行严重的精神和物质使用障碍以及自杀念头的筛查，并针对可能的策划者和尝试者进行干预，这一点很重要。
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