University Hospital and Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Hospital das Clínicas and Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Psychiatry Res. 2015 Feb 28;225(3):556-62. doi: 10.1016/j.psychres.2014.11.047. Epub 2014 Dec 4.
Suicidal ideation represents an important burden worldwide. However, little is known about it in low-/middle-income countries. We investigated this issue in a large cross-sectional of Brazilian civil servants (ELSA-Brasil, the Brazilian Health Longitudinal Study, n=15,105). Logistic univariate and multivariate analyses were performed to evaluate the strength of association (odds ratio, OR) between clinical and sociodemographic variables with acute life-weariness (tiredness of life) and suicidal thoughts. The presence of major depressive disorder (MDD), common mental disorders (CMDs), stressful life-events (SLEs) and poor self-perceived physical health was also collected. MDD and CMDs were strongly associated with suicidal ideation in univariate and multivariate analyses. For life-weariness thoughts, a modest, consistent association was found for female gender, being single, non-White ethnicity and poor education. SLEs and poor self-perceived physical health were also associated with suicidal ideation. Espiritism-Kardecism, but not other religions or Atheism/Agnosticism, was associated with lower rates of life-weariness and suicidal thoughts. To conclude, suicidal ideation does not differ in Brazil compared to developed countries, being primarily associated with psychiatric disorders and, to a lesser but significant extent, to social disadvantage, SLEs, poor self-perceived health and being single.
自杀意念是一个全球性的重要负担。然而，关于这一问题在中低收入国家的了解甚少。我们在巴西公务员的一项大型横断面研究（ELSA-Brasil，巴西健康纵向研究，n=15105）中调查了这一问题。采用单变量和多变量逻辑分析评估了临床和社会人口学变量与急性生活疲惫（对生活的厌倦）和自杀意念之间的关联强度（优势比，OR）。还收集了重性抑郁障碍（MDD）、常见精神障碍（CMDs）、生活应激事件（SLEs）和自我感知健康状况不佳的情况。在单变量和多变量分析中，MDD 和 CMDs 与自杀意念密切相关。对于生活疲惫的想法，女性、单身、非白种人种族和教育程度低与自杀意念呈中度一致相关。SLEs 和自我感知健康状况不佳也与自杀意念相关。唯灵论-卡德克主义与较低的生活疲惫和自杀意念相关，而其他宗教或无神论/不可知论则没有。总之，与发达国家相比，巴西的自杀意念没有差异，主要与精神障碍相关，其次是社会劣势、SLEs、自我感知健康状况不佳和单身。
