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J Clin Psychiatry. 2015 Mar;76(3):295-302. doi: 10.4088/JCP.14m09287.
To examine the prevalence and correlates of attempting suicide in the past 12 months among adults with past-year suicidal ideation in the United States.
Data were from 229,600 persons aged 18 years or older who participated in the 2008-2012 National Survey on Drug Use and Health. Among them, 12,300 reported having past-year suicidal ideation, and over 2,000 of those reported attempting suicide within the past 12 months prior to survey interview. Descriptive analyses and pooled and stratified (by suicide plan and major depressive episode [MDE]) multivariate logistic regression models were applied. Major depressive episode was based on assessments of individual diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
Among persons aged 18 years or older in the United States, 3.8% reported having suicidal ideation in the past 12 months. Among past-year suicidal ideators, 13.2% attempted suicide in the past 12 months. The prevalence of past 12-month suicide attempt among past-year ideators with MDE was higher than among those without MDE (14.1% vs 12.0%). Past 12-month suicide attempt was more common among ideators with a suicide plan than among ideators without a plan (37.0% vs 3.7%). However, the prevalence of suicide attempt was higher among ideators with a plan but without MDE than among ideators with a plan and MDE (42.1% vs 32.9%). Compared with ideators without a plan, ideators with a plan had a higher (adjusted odds ratio [AOR] = 2.2; 95% confidence interval [CI], 1.47-3.45) suicide attempt risk among those without MDE (AOR = 22.4; 95% CI,16.55-30.27) than among those with MDE (AOR = 10.7; 95% CI, 7.91-14.49).
Among adult suicidal ideators, factors associated with their progression from ideation to suicide attempt may vary by their suicide plan and major depression status. Focusing attention on high-risk subgroups may be warranted.
在美国，过去一年有过自杀意念的成年人中，过去 12 个月内尝试自杀的比例及其相关因素。
数据来自 2008-2012 年全国药物使用与健康调查的 229600 名 18 岁及以上的成年人。其中，12300 人报告过去一年有过自杀意念，其中 2000 多人在调查访谈前的过去 12 个月内报告有过自杀企图。应用描述性分析和汇总及分层（按自杀计划和重性抑郁发作[MDE]）多变量逻辑回归模型。重性抑郁发作是基于《精神障碍诊断与统计手册》第四版（DSM-IV）个体诊断标准的评估。
在美国，18 岁及以上成年人中，3.8%报告过去 12 个月有自杀意念。在过去一年有自杀意念的人群中，13.2%在过去 12 个月内有过自杀企图。有 MDE 的过去一年自杀意念者过去 12 个月自杀企图的发生率高于无 MDE 的自杀意念者（14.1%比 12.0%）。有自杀计划的自杀意念者过去 12 个月自杀企图的发生率高于无自杀计划的自杀意念者（37.0%比 3.7%）。然而，有自杀计划但无 MDE 的自杀意念者的自杀企图发生率高于有自杀计划和 MDE 的自杀意念者（42.1%比 32.9%）。与无计划的自杀意念者相比，有计划的自杀意念者无 MDE 时自杀企图的风险更高（调整后比值比[AOR] = 2.2；95%置信区间[CI]，1.47-3.45），而有 MDE 时自杀企图的风险更高（AOR = 22.4；95% CI，16.55-30.27）。
在成年自杀意念者中，从意念到自杀企图进展的相关因素可能因自杀计划和重度抑郁状态而异。关注高危亚组可能是必要的。
