School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
Centre for Rural and Remote Mental Health, University of Newcastle, Callaghan, NSW 2308, Australia.
Int J Environ Res Public Health. 2018 May 7;15(5):928. doi: 10.3390/ijerph15050928.
Suicide is a leading cause of death, particularly in rural and remote areas. Although depression is strongly related to both suicidal ideation and attempt, it lacks specificity as a predictor, and little is known about characteristics that increase suicide risk among people with depression. A telephone version of the World Mental Health Composite International Diagnostic Interview explored lifetime depression, suicidal ideation, suicide attempt, and related factors among a community-dwelling sample of rural and remote Australians, selected for an interview based on a screener for psychological distress (100% of those with high distress, 75% of those with moderate distress, and 16% of those with low distress). Of 1051 participants interviewed, 364 reported lifetime symptoms of depression; of these, 48% reported lifetime suicidal ideation and 16% reported a lifetime suicide attempt. While depression severity was a significant correlate of suicidality for both males and females, suicide attempt was significantly more common among females with a younger age of depression onset, and a higher number of psychiatric comorbidities. No additional factors were significant for males. Among rural and remote residents with lifetime symptoms of depression, the identification of suicide risk may be enhanced by considering individual and contextual factors beyond depression severity. Further research focusing on risk factors for males would be beneficial.
自杀是导致死亡的主要原因，尤其是在农村和偏远地区。虽然抑郁症与自杀意念和自杀企图密切相关，但它作为预测指标缺乏特异性，而且人们对增加抑郁症患者自杀风险的特征知之甚少。一项电话版的《世界心理健康综合国际诊断访谈》对农村和偏远地区澳大利亚社区居民中的终生抑郁、自杀意念、自杀企图以及相关因素进行了调查，该调查根据心理困扰筛查器对受访者进行了访谈（高困扰者 100%、中困扰者 75%、低困扰者 16%）。在接受访谈的 1051 名参与者中，有 364 人报告了一生中患有抑郁症的症状；其中，48%的人报告了一生中的自杀意念，16%的人报告了一生中的自杀企图。尽管抑郁严重程度是男性和女性自杀意念的显著相关因素，但在抑郁发病年龄较小、精神共病数量较多的女性中，自杀企图更为常见。对于男性来说，没有其他因素是显著的。在有终生抑郁症状的农村和偏远地区居民中，通过考虑抑郁严重程度以外的个体和环境因素，可能会更好地识别自杀风险。进一步关注男性风险因素的研究将是有益的。
