Fuller-Thomson Esme, Ramzan Natasha, Baird Stephanie L
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. W., Toronto, ON, M6S 3W6, Canada.
Rheumatol Int. 2016 Sep;36(9):1237-48. doi: 10.1007/s00296-016-3498-z. Epub 2016 Jun 14.
The objectives of this study were (1) to determine the odds of suicide attempts among those with arthritis compared with those without and to see what factors attenuate this association and (2) to identify which factors are associated with suicide attempts among adults with arthritis. Secondary data analysis of the nationally representative 2012 Canadian Community Health Survey-Mental Health (CCHS-MH) was performed. For objective 1, those with and without arthritis were included (n = 21,744). For objective 2, only individuals who had arthritis (n = 4885) were included. A series of binary logistic regression analyses of suicide attempts were conducted for each objective, with adjustments for socio-demographics, childhood adversities, lifetime mental health and chronic pain. After full adjustment for the above listed variables, the odds of suicide attempts among adults with arthritis were 1.46. Among those with arthritis, early adversities alone explained 24 % of the variability in suicide attempts. After full adjustment, the odds of suicide attempts among those with arthritis were significantly higher among those who had experienced childhood sexual abuse (OR = 3.77), chronic parental domestic violence (OR = 3.97) or childhood physical abuse (1.82), those who had ever been addicted to drugs or alcohol (OR = 1.76) and ever had a depressive disorder (OR = 3.22) or an anxiety disorder (OR = 2.34) and those who were currently in chronic pain (OR = 1.50). Younger adults with arthritis were more likely to report having attempted suicide. Future prospective research is needed to uncover plausible mechanisms through which arthritis and suicide attempts are linked.
（1）确定患有关节炎者与未患有关节炎者相比自杀未遂的几率，并探究哪些因素会减弱这种关联；（2）确定成年关节炎患者中与自杀未遂相关的因素。我们对具有全国代表性的2012年加拿大社区健康调查-心理健康（CCHS-MH）进行了二次数据分析。对于目标1，纳入了患有关节炎和未患有关节炎的人群（n = 21,744）。对于目标2，仅纳入了患有关节炎的个体（n = 4885）。针对每个目标，我们进行了一系列关于自杀未遂的二元逻辑回归分析，并对社会人口统计学、童年逆境、终生心理健康和慢性疼痛进行了调整。在对上述列出的变量进行全面调整后，成年关节炎患者自杀未遂的几率为1.46。在患有关节炎的人群中，仅早期逆境就解释了自杀未遂变异性的24%。全面调整后，在经历过童年性虐待（OR = 3.77）、长期遭受父母家庭暴力（OR = 3.97）或童年身体虐待（1.82）的人群中，在曾对药物或酒精成瘾（OR = 1.76）、曾患有抑郁症（OR = 3.22）或焦虑症（OR = 2.34）的人群中，以及在目前患有慢性疼痛（OR = 1.50）的患有关节炎的人群中，自杀未遂的几率显著更高。患有关节炎的年轻成年人更有可能报告曾尝试自杀。未来需要进行前瞻性研究，以揭示关节炎与自杀未遂之间存在联系的合理机制。
