Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts3Program on Integrative Knowledge and Human Flourishing, Institute.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
JAMA Psychiatry. 2016 Aug 1;73(8):845-51. doi: 10.1001/jamapsychiatry.2016.1243.
Previous studies have linked suicide risk with religious participation, but the majority have used ecologic, cross-sectional, or case-control data.
To examine the longitudinal association between religious service attendance and suicide and the joint associations of suicide with service attendance and religious affiliation.
DESIGN, SETTING, AND PARTICIPANTS: We evaluated associations between religious service attendance and suicide from 1996 through June 2010 in a large, long-term prospective cohort, the Nurses' Health Study, in an analysis that included 89 708 women. Religious service attendance was self-reported in 1992 and 1996. Data analysis was conducted from 1996 through 2010.
Cox proportional hazards regression models were used to examine the association between religious service attendance and suicide, adjusting for demographic covariates, lifestyle factors, medical history, depressive symptoms, and social integration measures. We performed sensitivity analyses to examine the influence of unmeasured confounding.
Among 89 708 women aged 30 to 55 years who participated in the Nurses' Health Study, attendance at religious services once per week or more was associated with an approximately 5-fold lower rate of suicide compared with never attending religious services (hazard ratio, 0.16; 95% CI, 0.06-0.46). Service attendance once or more per week vs less frequent attendance was associated with a hazard ratio of 0.05 (95% CI, 0.006-0.48) for Catholics but only 0.34 (95% CI, 0.10-1.10) for Protestants (P = .05 for heterogeneity). Results were robust in sensitivity analysis and to exclusions of persons who were previously depressed or had a history of cancer or cardiovascular disease. There was evidence that social integration, depressive symptoms, and alcohol consumption partially mediated the association among those occasionally attending services, but not for those attending frequently.
In this cohort of US women, frequent religious service attendance was associated with a significantly lower rate of suicide.
先前的研究已经将自杀风险与宗教参与联系起来，但大多数研究使用的是生态学、横断面或病例对照数据。
检查与宗教服务参与和自杀之间的纵向关联，以及自杀与服务参与和宗教信仰的联合关联。
设计、设置和参与者：我们在一项大型、长期前瞻性队列研究——护士健康研究中，评估了 1996 年至 2010 年 6 月期间宗教服务参与与自杀之间的关联，该分析包括 89708 名女性。宗教服务参与情况于 1992 年和 1996 年进行了自我报告。数据分析于 1996 年至 2010 年进行。
使用 Cox 比例风险回归模型来检验宗教服务参与与自杀之间的关联，调整了人口统计学协变量、生活方式因素、病史、抑郁症状和社会融合措施。我们进行了敏感性分析，以检验未测量混杂因素的影响。
在参与护士健康研究的 89708 名年龄在 30 岁至 55 岁之间的女性中，每周参加一次或多次宗教服务与自杀率降低约 5 倍相关（危险比，0.16；95%CI，0.06-0.46）。每周一次或多次参加服务与较少频率参加服务相关的危险比为 0.05（95%CI，0.006-0.48），对于天主教徒，而对于新教徒则为 0.34（95%CI，0.10-1.10）（P 值=异质性检验，0.05）。敏感性分析和排除先前患有抑郁症或患有癌症或心血管疾病的人后，结果仍然稳健。有证据表明，社交融合、抑郁症状和饮酒部分解释了偶尔参加服务者之间的关联，但对于经常参加服务者则没有。
在这项美国女性队列研究中，频繁的宗教服务参与与自杀率显著降低相关。
