Handley T E, Ventura A D, Browne J L, Rich J, Attia J R, Reddy P, Pouwer F, Speight J
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW.
National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW.
Diabet Med. 2016 Nov;33(11):1582-1589. doi: 10.1111/dme.13022. Epub 2015 Dec 8.
To examine the prevalence and correlates of suicidal ideation (SI) in a community-based sample of adults with Type 1 or Type 2 diabetes.
Participants were 3338 adults aged 18-70 years with Type 1 diabetes (n = 1376) or Type 2 diabetes (non-insulin: n = 1238; insulin: n = 724) from a national survey administered to a random sample registered with the National Diabetes Services Scheme. Depression and SI were assessed using the Patient Health Questionnaire, and diabetes-specific distress with the Problem Areas In Diabetes scale. Separate logistic regression analyses by diabetes type/treatment were used to determine relative contribution to SI.
Overall, we observed a SI rate of 14% in our sample. Participants with Type 2 diabetes using insulin reported more frequent depressive symptoms, and were more likely to report recent SI (19%) compared with those with either Type 1 diabetes or Type 2 diabetes not using insulin (14 and 12%, respectively). After controlling for depression, there was little difference in the prevalence of SI between diabetes types/treatments, but higher diabetes-specific distress significantly increased the odds of SI.
As SI is a significant risk factor for a suicide attempt, the findings have implications for healthcare professionals, pointing to the importance of adequate screening and action plans for appropriate follow-up of those reporting depression. Our findings are also indicative of the psychological toll of diabetes more generally, and the need to integrate physical and mental healthcare for people with diabetes.
在一个基于社区的1型或2型糖尿病成年样本中，研究自杀意念（SI）的患病率及其相关因素。
参与者为3338名年龄在18至70岁之间的成年人，他们来自一项对在国家糖尿病服务计划中登记的随机样本进行的全国性调查，其中1型糖尿病患者1376名，2型糖尿病患者（非胰岛素治疗：1238名；胰岛素治疗：724名）。使用患者健康问卷评估抑郁和自杀意念，使用糖尿病问题领域量表评估糖尿病特异性困扰。通过糖尿病类型/治疗方法进行单独的逻辑回归分析，以确定对自杀意念的相对影响。
总体而言，我们在样本中观察到自杀意念发生率为14%。与1型糖尿病患者或未使用胰岛素的2型糖尿病患者（分别为14%和12%）相比，使用胰岛素的2型糖尿病患者报告的抑郁症状更频繁，且更有可能报告近期有自杀意念（19%）。在控制抑郁因素后，不同糖尿病类型/治疗方法之间自杀意念的患病率差异不大，但较高的糖尿病特异性困扰显著增加了自杀意念的几率。
由于自杀意念是自杀未遂的一个重要危险因素，这些发现对医疗保健专业人员具有启示意义，表明对报告有抑郁症状的患者进行充分筛查和制定适当后续行动计划的重要性。我们的发现还更普遍地表明了糖尿病对心理的影响，以及为糖尿病患者整合身心医疗保健的必要性。
