Pitman Alexandra, Rantell Khadija, Marston Louise, King Michael, Osborn David
UCL Division of Psychiatry, University College London, London W1T 7NF, UK.
Camden and Islington NHS Foundation Trust, London NW1 0PE, UK.
Int J Environ Res Public Health. 2017 Mar 9;14(3):286. doi: 10.3390/ijerph14030286.
The sudden death of a friend or relative, particularly by suicide, is a risk factor for suicide. People who experience sudden bereavement report feeling highly stigmatised by the loss, potentially influencing access to support. We assessed whether perceived stigma following sudden bereavement is associated with suicidal thoughts and suicide attempt. We analysed cross-sectional survey data on 3387 young adults bereaved by the sudden death of a close contact. We tested the association of high versus low perceived stigma (on the stigma sub-scale of the Grief Experience Questionnaire) with post-bereavement suicidal ideation and suicide attempt, using random effects logistic regression, adjusting for socio-demographic factors, pre-bereavement psychopathology, and mode of sudden bereavement (natural causes/unnatural causes/suicide). Subjects with high perceived stigma scores were significantly more likely to report post-bereavement suicidal thoughts (adjusted odds ratio (AOR) = 2.74; 95% confidence interval (CI) = 1.93-3.89) and suicide attempt (AOR = 2.73; 95% CI = 2.33-3.18) than those with low stigma scores. People who feel highly stigmatised by a sudden bereavement are at increased risk of suicidal thoughts and suicide attempt, even taking into account prior suicidal behaviour. General practitioners, bereavement counsellors, and others who support people bereaved suddenly, should consider inquiring about perceived stigma, mental wellbeing, and suicidal thoughts, and directing them to appropriate sources of support.
朋友或亲属的突然离世,尤其是自杀身亡,是自杀的一个风险因素。经历突然丧亲之痛的人表示,他们因这种损失而深感耻辱,这可能会影响他们获得支持的机会。我们评估了突然丧亲后所感受到的耻辱感是否与自杀念头和自杀未遂有关。我们分析了3387名因亲密接触者突然死亡而 bereaved 的年轻人的横断面调查数据。我们使用随机效应逻辑回归,在调整了社会人口学因素、丧亲前的精神病理学状况以及突然丧亲的方式(自然原因/非自然原因/自杀)之后,测试了高与低感知耻辱感(在悲伤经历问卷的耻辱感子量表上)与丧亲后的自杀意念和自杀未遂之间的关联。与低耻辱感得分者相比,高耻辱感得分的受试者报告丧亲后自杀念头(调整后的优势比(AOR)= 2.74;95%置信区间(CI)= 1.93 - 3.89)和自杀未遂(AOR = 2.73;95% CI = 2.33 - 3.18)的可能性显著更高。即使考虑到先前的自杀行为,因突然丧亲而深感耻辱的人出现自杀念头和自杀未遂的风险也会增加。全科医生、丧亲辅导员以及其他支持突然丧亲者的人,应该考虑询问他们所感受到的耻辱感、心理健康状况和自杀念头,并引导他们寻求适当的支持来源。