Xu Huilan, Qin Lulu, Wang Jinhong, Zhou Liang, Luo Dan, Hu Mi, Li Zhenhua, Xiao Shuiyuan
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
BMJ Open. 2016 Apr 15;6(4):e010914. doi: 10.1136/bmjopen-2015-010914.
To identify risk factors, and their interactions, for suicidal ideation among the elderly in rural communities of Hunan and to provide some scientific basis for suicide prevention.
DESIGN, SETTING AND PARTICIPANTS: A cross-sectional survey was conducted among the elderly in rural communities in China's Hunan Province. Thirteen areas were selected by multi-staged cluster random sampling, and 1887 rural elders were investigated via face-to-face interviews.
Measures included sociodemographic information, suicidal ideation, activities of daily living (ADL), major depression disorder (MDD), drinking, stressful life events and social support. Non-conditional logistic regression was preformed to explore the influencing factors for suicidal ideation, and additive interaction was used to analyse the interaction between risk factors.
Incidence of suicidal ideation among the elderly was 14.5% (95% CI 12.9% to 16.1%) in rural communities of Hunan. The independent influencing factors for suicidal ideation were annual personal income (OR 3.14; 95% CI 2.15 to 4.59), MDD (OR 17.04; 95% CI 11.91 to 24.39), chronic diseases (OR 2.99; 95% CI 1.84 to 4.85) and ADL (OR 2.00; 95% CI 1.37 to 2.94). Additive interactions were detected between MDD and ADL with a relative excess risk of interaction (RERI) of 21.18 (95% CI 5.47 to 36.89), and between MDD and annual personal income with an RERI of 35.00 (95% CI 9.00 to 61.00).
The independent risk factors for suicidal ideation are annual personal income (≤2200 CNY), MDD, chronic diseases and disabled ADL status. MDD has additive interactions with ADL and annual personal income. These findings have significant implications for the prediction and prevention of suicidal behaviours.
识别湖南农村社区老年人自杀意念的危险因素及其相互作用，为自杀预防提供科学依据。
设计、地点和参与者：在中国湖南省农村社区的老年人中进行了一项横断面调查。通过多阶段整群随机抽样选取了13个地区，并通过面对面访谈对1887名农村老年人进行了调查。
测量指标包括社会人口学信息、自杀意念、日常生活活动能力（ADL）、重度抑郁症（MDD）、饮酒、应激性生活事件和社会支持。采用非条件逻辑回归探讨自杀意念的影响因素，并采用相加交互作用分析危险因素之间的相互作用。
湖南农村社区老年人自杀意念发生率为14.5%（95%CI 12.9%至16.1%）。自杀意念的独立影响因素为个人年收入（OR 3.14；95%CI 2.15至4.59）、重度抑郁症（OR 17.04；95%CI 11.91至24.39）、慢性病（OR 2.99；95%CI 1.84至4.85）和日常生活活动能力（OR 2.00；95%CI 1.37至2.94）。在重度抑郁症与日常生活活动能力之间检测到相加交互作用，交互作用的相对超额危险度（RERI）为21.18（95%CI 5.47至36.89），在重度抑郁症与个人年收入之间检测到相加交互作用，交互作用的相对超额危险度为35.00（95%CI 9.00至61.00）。
自杀意念的独立危险因素为个人年收入（≤2200元人民币）、重度抑郁症、慢性病和日常生活活动能力受损状态。重度抑郁症与日常生活活动能力和个人年收入之间存在相加交互作用。这些发现对自杀行为的预测和预防具有重要意义。
