1 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario.
2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.
Can J Psychiatry. 2017 Dec;62(12):845-853. doi: 10.1177/0706743717727242. Epub 2017 Aug 17.
The aims of this study were to estimate the: (1) 12-mo prevalence of suicidal thoughts, plans, and attempts in a population sample of adolescents and young adults with and without chronic illness; (2) associations among chronic illness and suicidal thoughts and behaviour (STB); and, (3) moderating roles of mood and substance use disorder on this association.
Individuals were aged 15 to 30 y ( n = 5,248) from the Canadian Community Health Survey-Mental Health. Twelve-month STB and psychiatric disorder were measured using the World Health Organization Composite International Diagnostic Interview 3.0. Multinomial logistic regression examined associations between chronic illness and STB, adjusting for relevant sociodemographic and health characteristics. Product term interactions among chronic illness, mood, and substance use disorders were included in the regression models to examine potential moderating effects.
Prevalence of suicidal thoughts, plans, and attempts was higher in individuals with chronic illness ( P < 0.01 for all). After adjustment, chronic illness increased the odds for suicidal thoughts [OR = 1.28 (1.01 to 1.64)], plans [OR = 2.34 (1.22 to 4.39)], and attempts [OR = 4.63 (1.52 to 14.34)]. In the presence v. absence of a mood disorder, the odds for suicidal thoughts were higher among individuals with chronic illness [OR = 1.89 (1.06 to 5.28)].
Suicidal thoughts and behaviours are common among adolescents and young adults with chronic illness, particularly among those with comorbid mood disorders. Health professionals should routinely ask about STB during assessments of their adolescent and young adult patients.
本研究旨在:(1)评估患有和不患有慢性疾病的青少年和年轻成年人人群样本中,自杀想法、计划和尝试在 12 个月内的流行率;(2)慢性疾病与自杀想法和行为(STB)之间的关联;以及,(3)情绪和物质使用障碍对这种关联的调节作用。
该研究的参与者年龄在 15 至 30 岁之间(n=5248),来自加拿大社区健康调查-心理健康调查。使用世界卫生组织综合国际诊断访谈 3.0 来衡量 12 个月内的 STB 和精神疾病。多变量逻辑回归检验了慢性疾病与 STB 之间的关联,调整了相关的社会人口统计学和健康特征。在回归模型中包含了慢性疾病、情绪和物质使用障碍之间的乘积项交互作用,以检验潜在的调节作用。
患有慢性疾病的个体自杀想法、计划和尝试的发生率更高(所有 P<0.01)。调整后,慢性疾病增加了自杀想法的可能性[OR=1.28(1.01 至 1.64)]、计划[OR=2.34(1.22 至 4.39)]和尝试[OR=4.63(1.52 至 14.34)]。在存在和不存在情绪障碍的情况下,患有慢性疾病的个体自杀想法的可能性更高[OR=1.89(1.06 至 5.28)]。
患有慢性疾病的青少年和年轻成年人中自杀想法和行为很常见,尤其是那些患有共病情绪障碍的人。卫生专业人员在评估青少年和年轻成年人患者时,应常规询问自杀想法和行为。