Marchand Kirsten, Palis Heather, Fikowski Jill, Harrison Scott, Spittal Patricia, Schechter Martin T, Oviedo-Joekes Eugenia
1 Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St Paul's Hospital, Vancouver, British Columbia.
2 School of Population and Public Health, University of British Columbia, Vancouver, British Columbia.
Can J Psychiatry. 2017 Jul;62(7):465-472. doi: 10.1177/0706743717711173. Epub 2017 May 18.
This study aims to examine factors associated with suicidal ideation among people with opioid dependence and to explore whether these factors are gender-specific.
Cross-sectional data were collected among long-term opioid-dependent individuals ( n = 176; 46.0% women). Lifetime histories of suicidal ideation were measured using the Composite International Diagnostic Interview, and additional data were collected regarding sociodemographic characteristics, drug use, health, and adverse life events. Multivariable logistic regression was used to determine the relationships between these variables and suicidal ideation for the full study sample and separately for women and men to explore the potential role of gender.
A total of 43.8% ( n = 77) of participants reported a lifetime history of suicidal ideation. Among those with suicidal ideation, 49.3% were women and the overall average age of first ideation was 19.82 years (SD, 11.66 years). Results from multivariable analyses showed that a history of depression, anxiety, and childhood emotional neglect and the number of lifetime traumatic events were significantly associated with higher odds of suicidal ideation. The gender-based analysis suggested that histories of depression and anxiety remained independently associated with lifetime suicidal ideation among women, whereas for men, childhood emotional neglect and the number of lifetime potentially traumatic events were independently associated with lifetime suicidal ideation.
This study offers a critical first step to understanding factors associated with suicidal ideation among long-term opioid-dependent men and women and the potential importance of gender-sensitive approaches for suicidal behavior interventions. These data inform further research and clinical opportunities aiming to better respond to the psychological health needs of this population.
本研究旨在探讨阿片类药物依赖者自杀意念的相关因素，并探究这些因素是否存在性别差异。
收集长期阿片类药物依赖个体（n = 176；46.0%为女性）的横断面数据。使用复合国际诊断访谈量表测量自杀意念的终生史，并收集有关社会人口学特征、药物使用、健康状况和不良生活事件的额外数据。采用多变量逻辑回归分析确定这些变量与整个研究样本以及分别按性别划分的自杀意念之间的关系，以探究性别的潜在作用。
共有43.8%（n = 77）的参与者报告有自杀意念的终生史。在有自杀意念的人群中，49.3%为女性，首次出现自杀意念的总体平均年龄为19.82岁（标准差为11.66岁）。多变量分析结果显示，抑郁、焦虑病史、童年期情感忽视以及终生创伤事件的数量与自杀意念的较高几率显著相关。基于性别的分析表明，抑郁和焦虑病史在女性中仍与终生自杀意念独立相关，而对于男性而言，童年期情感忽视和终生潜在创伤事件的数量与终生自杀意念独立相关。
本研究为理解长期阿片类药物依赖的男性和女性自杀意念的相关因素以及性别敏感方法在自杀行为干预中的潜在重要性提供了关键的第一步。这些数据为进一步的研究和临床实践提供了参考，旨在更好地满足这一人群的心理健康需求。
