Department of Internal Medicine/Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
J Clin Psychiatry. 2015 Mar;76(3):e359-65. doi: 10.4088/JCP.13m08864.
Suicide is an important worldwide public health problem. The aim of this study was to characterize risk factors of suicidal behavior using a large Web-based sample.
The data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) from November 2010 to July 2011. Suicidal behavior was assessed by an instrument based on the Suicidal Behaviors Questionnaire. The final sample consisted of 48,569 volunteers (25.9% men) with a mean ± SD age of 30.7 ± 10.1 years.
More than 60% of the sample reported having had at least a passing thought of killing themselves, and 6.8% of subjects had previously attempted suicide (64% unplanned). The demographic features with the highest risk of attempting suicide were female gender (OR = 1.82, 95% CI = 1.65 to 2.00); elementary school as highest education level completed (OR = 2.84, 95% CI = 2.48 to 3.25); being unable to work (OR = 5.32, 95% CI = 4.15 to 6.81); having no religion (OR = 2.08, 95% CI = 1.90 to 2.29); and, only for female participants, being married (OR = 1.19, 95% CI = 1.08 to 1.32) or divorced (OR = 1.66, 95% CI = 1.41 to 1.96). A family history of a suicide attempt and of a completed suicide showed the same increment in the risk of suicidal behavior. The higher the number of suicide attempts, the higher was the real intention to die (P < .05). Those who really wanted to die reported more emptiness/loneliness (OR = 1.58, 95% CI = 1.35 to 1.85), disconnection (OR = 1.54, 95% CI = 1.30 to 1.81), and hopelessness (OR = 1.74, 95% CI = 1.49 to 2.03), but their methods were not different from the methods of those who did not mean to die.
This large Web survey confirmed results from previous studies on suicidal behavior and pointed out the relevance of the number of previous suicide attempts and of a positive family history, even for a noncompleted suicide, as important risk factors.
自杀是一个重要的全球性公共卫生问题。本研究旨在使用大型网络样本描述自杀行为的危险因素。
该数据由巴西互联网特质与精神病理学研究（BRAINSTEP）于 2010 年 11 月至 2011 年 7 月收集。自杀行为通过基于自杀行为问卷的工具进行评估。最终样本由 48569 名志愿者（25.9%为男性）组成，平均年龄为 30.7±10.1 岁。
超过 60%的样本报告至少有过一次自杀念头，6.8%的受试者曾试图自杀（64%为非计划性）。尝试自杀风险最高的人口统计学特征为女性（OR=1.82，95%CI=1.65 至 2.00）；完成的最高教育水平为小学（OR=2.84，95%CI=2.48 至 3.25）；无法工作（OR=5.32，95%CI=4.15 至 6.81）；没有宗教信仰（OR=2.08，95%CI=1.90 至 2.29）；仅对女性参与者而言，已婚（OR=1.19，95%CI=1.08 至 1.32）或离婚（OR=1.66，95%CI=1.41 至 1.96）。自杀尝试和自杀完成的家族史同样增加了自杀行为的风险。自杀尝试次数越多，真正想死的意愿越高（P<.05）。那些真的想死的人报告说，他们感到更加空虚/孤独（OR=1.58，95%CI=1.35 至 1.85）、脱节（OR=1.54，95%CI=1.30 至 1.81）和绝望（OR=1.74，95%CI=1.49 至 2.03），但他们的自杀方法与那些不想死的人并无不同。
这项大型网络调查证实了先前关于自杀行为的研究结果，并指出了之前自杀尝试次数和阳性家族史的重要性，即使是未完成的自杀，也是重要的危险因素。
