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6818例自杀未遂者中成瘾与精神障碍的不平等:用分解法确定决定因素的积极贡献

Inequality in Addiction and Mental Disorders in 6818 Suicide Attempts: Determine of Positive Contribution of Determinants by Decomposition Method.

作者信息

Veisani Yousef, Delpisheh Ali, Moradi Ghobad, Hassanzadeh Jafar, Sayehmiri Kourosh

机构信息

Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.

Dept. of Clinical Epidemiology, School of Health, Ilam University of Medical Sciences, Ilam, Iran.

出版信息

Iran J Public Health. 2017 Jun;46(6):796-803.

Abstract

BACKGROUND

Unpleasant health outcomes are common in deprived communities and have been shown a direct connection between socioeconomic status and wellbeing but, the effect of the socioeconomic status on suicide is currently controversial. This study explored the relationship of the socioeconomic status and addiction and mental disorders in suicide attempts and decomposed inequalities into its determinants to calculating share of contribution to the inequality.

METHODS

This cross-sectional study recognized 546 suicide deaths and 6818 attempted suicides from 1 Jan 2010 to 31 Dec 2014 in Ilam Province, West of Iran. Inequality measured by concentration index (CI) and decomposing contribution in inequality. All analysis was performed by standard statistical software, Stata (Ver. 11.2).

RESULTS

The pooled rate of death in people with suicide attempts was 8.0% and that of having a history of suicide was 5.2%. The overall CI for addiction was -0.233 (95% CI= -0.383 to -0.084), and the CI for mental disorders was 0.0006 (95% CI = -0.009 to 0.010). The more amount of contribution to socioeconomic inequality in suicide attempts because of age group of < 25 yr (26%), socioeconomic level (23%), and marital status (22%).

CONCLUSION

Addiction and mental disorders were distributed among suicide attempters unequally and gap between advantaged and disadvantaged attempted suicide confirmed by our results. Addiction prevention-related policies and programmers' should be focus on disadvantaged groups.

摘要

背景

不良健康后果在贫困社区很常见,并且已表明社会经济地位与幸福感之间存在直接联系,但是,社会经济地位对自杀的影响目前存在争议。本研究探讨了社会经济地位与自杀未遂中成瘾和精神障碍之间的关系,并将不平等分解为其决定因素,以计算对不平等的贡献份额。

方法

这项横断面研究识别了2010年1月1日至2014年12月31日期间伊朗西部伊拉姆省的546例自杀死亡和6818例自杀未遂案例。通过集中指数(CI)测量不平等,并分解不平等中的贡献。所有分析均使用标准统计软件Stata(版本11.2)进行。

结果

自杀未遂者的合并死亡率为8.0%,有自杀史者的合并死亡率为5.2%。成瘾的总体CI为-0.233(95%CI=-0.383至-0.084),精神障碍的CI为0.0006(95%CI=-0.009至0.010)。由于年龄小于25岁(26%)、社会经济水平(23%)和婚姻状况(22%),自杀未遂中对社会经济不平等的贡献量更大。

结论

成瘾和精神障碍在自杀未遂者中分布不均,我们的结果证实了优势和劣势自杀未遂者之间的差距。与成瘾预防相关的政策和项目应关注弱势群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e58/5558073/f36c3f05bb95/IJPH-46-796-g001.jpg

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