National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico.
University of Wisconsin-Madison, Madison, WI, USA.
Suicide Life Threat Behav. 2018 Dec;48(6):755-766. doi: 10.1111/sltb.12397. Epub 2017 Oct 3.
In recent years, Mexico has seen one of the largest increases in suicide rates worldwide, especially among adolescents and young adults. This study uses data from the 1,071 respondents who participated in a two-wave longitudinal study when they were between 12 and 17 years of age, and again when they were between 19 and 26 years of age. The World Mental Health Composite International Diagnostic Interview assessed suicidal behavior and DSM-IV mental disorders. We used Cox regressions to evaluate which sociodemographic and psychiatric factors and life events predicted the incidence and remission of suicide ideation, plan, and attempt throughout the 8-year span. The 8-year incidence of suicide ideation, plan, and attempt was 13.3%, 4.8%, and 5.9%, respectively. We found that the number of traumatic life events during childhood, no longer being in school, and tobacco use predicted which adolescents developed suicide behaviors as they transitioned into young adulthood. Psychiatric disorders, particularly anxiety disorders, played a larger role in the persistence of those who already had suicidal behaviors, while behavioral disorders played a role in the transition from ideation to attempt. This distinction may be useful for clinicians to assess the risk of suicide.
近年来,墨西哥的自杀率在全球范围内增长最快,尤其是在青少年和年轻人中。本研究使用了参加了两次纵向研究的 1071 名受访者的数据,这些受访者在 12 至 17 岁时和 19 至 26 岁时参加了研究。世界心理健康综合国际诊断访谈评估了自杀行为和 DSM-IV 精神障碍。我们使用 Cox 回归评估了哪些社会人口统计学和精神卫生因素以及生活事件预测了自杀意念、计划和尝试在 8 年期间的发生率和缓解率。自杀意念、计划和尝试的 8 年发生率分别为 13.3%、4.8%和 5.9%。我们发现,童年时期创伤性生活事件的数量、不再上学和吸烟预测了哪些青少年在进入青年期时会出现自杀行为。精神障碍,特别是焦虑障碍,在那些已经有自杀行为的人中,对其持续存在起着更大的作用,而行为障碍则在从意念到尝试的转变中起着作用。这种区别可能对临床医生评估自杀风险有用。