Kitagawa Yuko, Ando Shuntaro, Yamasaki Syudo, Foo Jerome Clifford, Okazaki Yuji, Shimodera Shinji, Nishida Atsushi, Togo Fumiharu, Sasaki Tsukasa
Department of Physical and Health Education, Graduate School of Education, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan; Japan Society for the Promotion of Science, 5-3-1, Koujimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.
Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan.
Appetite. 2017 Apr 1;111:7-11. doi: 10.1016/j.appet.2016.12.026. Epub 2016 Dec 21.
Suicide is a leading cause of death in adolescents, but detection of its risk is often challenging. Many mental illnesses share the common symptom of appetite loss and it is also known that people who suffer from these illnesses are at greater risk of suicide. However, the relationship between appetite loss and suicide risk has yet to be examined. For adolescents in particular, questions about appetite loss may be easier to answer than sensitive questions regarding mental health. The present study aims to investigate the association of appetite loss with suicidal ideation and self-harm in adolescents. Rates of adolescents with suicidal ideation or self-harm associated with appetite-loss were examined in 18,250 Japanese junior and senior high school students (aged 12-18) using a self-report questionnaire. Insomnia, a physical symptom which has previously been associated with suicide risk, was also controlled for in the analysis. Results showed that rates of adolescents with suicidal ideation or self-harm significantly increased according to the degree of self-reported appetite loss. Similar results were observed for insomnia. Odds ratios (ORs) for suicidal ideation and self-harm were 5.5 and 4.1 for adolescents with appetite loss compared to those without it, and the ORs were 5.5 and 3.5 for those with insomnia compared to those without it, respectively, adjusting for sex and age (p < 0.001). ORs remained statistically significant after adjusting for depression/anxiety (General Health Questionnaire-12 score). In conclusion, self-reported appetite loss was highly associated with suicidal ideation and self-harm in adolescents; adolescents reporting physical symptoms such as loss of appetite or insomnia should be given careful attention.
自杀是青少年死亡的主要原因之一，但对其风险的检测往往具有挑战性。许多精神疾病都有食欲不振这一共同症状，而且众所周知，患有这些疾病的人自杀风险更高。然而，食欲不振与自杀风险之间的关系尚未得到研究。特别是对于青少年来说，关于食欲不振的问题可能比有关心理健康的敏感问题更容易回答。本研究旨在调查青少年食欲不振与自杀意念及自我伤害之间的关联。通过一份自填问卷，对18250名日本初、高中学生（年龄在12 - 18岁）中与食欲不振相关的有自杀意念或自我伤害行为的青少年比例进行了调查。分析中还对先前已被证明与自杀风险相关的身体症状——失眠进行了控制。结果显示，根据自我报告的食欲不振程度，有自杀意念或自我伤害行为的青少年比例显著增加。失眠情况也观察到了类似结果。与没有食欲不振的青少年相比，有食欲不振的青少年出现自杀意念和自我伤害行为的优势比（OR）分别为5.5和4.1；与没有失眠的青少年相比，有失眠的青少年出现自杀意念和自我伤害行为的OR分别为5.5和3.5，在对性别和年龄进行调整后（p < 0.001）。在对抑郁/焦虑（一般健康问卷 - 12得分）进行调整后，OR仍具有统计学意义。总之，自我报告的食欲不振与青少年的自杀意念和自我伤害行为高度相关；对于报告有食欲不振或失眠等身体症状的青少年应给予密切关注。
