Department of Public Health Medical Services, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Republic of Korea.
Department of Psychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Republic of Korea.
Depress Anxiety. 2018 Nov;35(11):1095-1103. doi: 10.1002/da.22803. Epub 2018 Jul 20.
There has been a strong association between posttraumatic stress disorder (PTSD) and suicidal ideation, which are both major mental health concerns in firefighters. Alcohol use disorders (AUDs) and insomnia are linked with both PTSD and suicidal ideation, but no studies have examined whether the relationship between PTSD and suicidal ideation can be explained by AUDs and insomnia. The purpose of this study was to investigate the mediating role of AUDs and insomnia in the relationship between PTSD symptoms and suicidal ideation.
A total of 7190 Korean firefighters filled out self-reported questionnaires to assess the number of exposure to incident stressors and the severity of PTSD symptoms, suicidal ideation, AUDs, and insomnia. Hierarchical multivariable linear regression analyses were performed to identify the relationship of AUDs and insomnia with suicidal ideation. Path analyses were applied to investigate the mediation effects of AUDs and insomnia on the relationship between PTSD symptoms and suicidal ideation.
AUDs and insomnia showed significant associations with suicidal ideation, even after adjusting for demographic factors, number of traumatic events, and PTSD symptoms. The relationship between PTSD symptoms and suicidal ideation was partially mediated by AUDs and insomnia. AUDs also had both direct and indirect effects on suicidal ideation, with the indirect effect mediated by insomnia.
We presented a model in which AUDs and insomnia mediate the relationship between PTSD symptoms and suicidal ideation in firefighters. Efforts to treat AUDs and alleviate insomnia could be beneficial in minimizing suicidal ideation in firefighters.
创伤后应激障碍（PTSD）和自杀意念之间存在很强的关联，这两者都是消防员主要关注的心理健康问题。酒精使用障碍（AUD）和失眠与 PTSD 和自杀意念都有关联，但没有研究检查 PTSD 和自杀意念之间的关系是否可以用 AUD 和失眠来解释。本研究的目的是调查 AUD 和失眠在 PTSD 症状与自杀意念之间的关系中的中介作用。
共有 7190 名韩国消防员填写了自我报告问卷，以评估暴露于事件应激源的次数和 PTSD 症状、自杀意念、AUD 和失眠的严重程度。进行分层多变量线性回归分析，以确定 AUD 和失眠与自杀意念的关系。路径分析用于调查 PTSD 症状与自杀意念之间的关系中 AUD 和失眠的中介作用。
即使在调整了人口统计学因素、创伤事件数量和 PTSD 症状后，AUD 和失眠与自杀意念仍存在显著关联。AUD 和失眠部分中介了 PTSD 症状和自杀意念之间的关系。AUD 对自杀意念也有直接和间接的影响，其间接影响通过失眠介导。
我们提出了一个模型，即 AUD 和失眠在消防员的 PTSD 症状和自杀意念之间起中介作用。治疗 AUD 和减轻失眠可能有助于最大限度地减少消防员的自杀意念。
