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焦虑的初级保健患者中死亡和自杀意念的年龄差异。

Age Differences in Death and Suicidal Ideation in Anxious Primary Care Patients.

机构信息

a University of Southern California , Los Angeles , California , USA.

b VA San Diego Healthcare System , San Diego , California , USA.

出版信息

Clin Gerontol. 2018 Jul-Sep;41(4):271-281. doi: 10.1080/07317115.2017.1356893. Epub 2017 Sep 29.

Abstract

OBJECTIVES

The objective of this study was to examine age differences in the likelihood of endorsing of death and suicidal ideation in primary care patients with anxiety disorders.

METHOD

Participants were drawn from the Coordinated Anxiety Learning and Management (CALM) Study, an effectiveness trial for primary care patients with panic disorder (PD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and/or social anxiety disorder (SAD).

RESULTS

Approximately one third of older adults with anxiety disorders reported feeling like they were better off dead. Older adults with PD and SAD were more likely to endorse suicidal ideation lasting at least more than half the prior week compared with younger adults with these disorders. Older adults with SAD endorsed higher rates of suicidal ideation compared with older adults with other anxiety disorders. Multivariate analyses revealed the importance of physical health, social support, and comorbid MDD in this association.

CONCLUSIONS

Suicidal ideation is common in anxious, older, primary care patients and is particularly prevalent in socially anxious older adults. Findings speak to the importance of physical health, social functioning, and MDD in this association.

CLINICAL IMPLICATIONS

When working with anxious older adults it is important to conduct a thorough suicide risk assessment and teach skills to cope with death and suicidal ideation-related thoughts.

摘要

目的

本研究旨在探讨在初级保健患者中,焦虑障碍患者年龄差异与死亡和自杀意念的关系。

方法

参与者来自协调焦虑学习和管理(CALM)研究,这是一项针对惊恐障碍(PD)、广泛性焦虑障碍(GAD)、创伤后应激障碍(PTSD)和/或社交焦虑障碍(SAD)的初级保健患者的有效性试验。

结果

约三分之一的老年焦虑障碍患者表示想死。与年轻患者相比,患有 PD 和 SAD 的老年患者更有可能出现持续至少超过前一周一半时间的自杀意念。与其他焦虑障碍患者相比,患有 SAD 的老年患者自杀意念的发生率更高。多变量分析显示,身体健康、社会支持和共患 MDD 在这种关联中很重要。

结论

自杀意念在焦虑的老年初级保健患者中很常见,在社交焦虑的老年患者中更为普遍。这些发现表明身体健康、社会功能和 MDD 在这种关联中的重要性。

临床意义

在与焦虑的老年患者合作时,进行全面的自杀风险评估和教授应对死亡和自杀意念相关想法的技能非常重要。

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