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慢性疼痛患者自杀意念缓解:哪些因素与韧性有关?

Remission From Suicidal Ideation Among Those in Chronic Pain: What Factors Are Associated With Resilience?

机构信息

Institute for Life Course & Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.

Institute for Life Course & Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Pain. 2019 Sep;20(9):1048-1056. doi: 10.1016/j.jpain.2019.02.096. Epub 2019 Apr 9.

Abstract

Although there have been many studies on the link between chronic pain and suicidality, surprisingly little research has focused on resilience and recovery among those in chronic and disabling pain who have had suicidal thoughts. The objectives of this study were to identify the prevalence and correlates of recovery from suicidal thoughts among those in chronic pain. A secondary analysis of a nationally representative sample of Canadians in chronic and disabling pain who had ever had serious suicidal thoughts (N = 635) was conducted to identify the prevalence and characteristics of those who are no longer considering suicide. Data were drawn from the Canadian Community Health Survey-Mental Health. Three in five Canadians in chronic pain (63%) who had seriously considered suicide at some point in their life had been free of these thoughts in the past year. Those free of suicidal ideation were significantly more likely to be older, women, white, better educated, with a confidant, and to use spirituality to cope, but less likely to have low household incomes, difficulties meeting basic expenses, and a history of depression and anxiety disorders. PERSPECTIVE: Almost two-thirds of formerly suicidal Canadians with chronic pain were free from suicidal thoughts in the past year. These findings provide a hopeful message of resilience and recovery in the context of disabling pain and help to improve targeted outreach to those most at risk for unremitting suicidality.

摘要

尽管有许多关于慢性疼痛与自杀意念之间关联的研究,但令人惊讶的是,很少有研究关注那些有慢性和致残性疼痛且曾有过自杀想法的人的韧性和康复。本研究的目的是确定在慢性疼痛人群中,从自杀意念中恢复的发生率和相关因素。对曾有过严重自杀意念的加拿大慢性和致残性疼痛人群(n=635)的全国代表性样本进行了二次分析,以确定那些不再考虑自杀的人群的发生率和特征。数据来自加拿大社区健康调查-心理健康。在过去一年中,有五分之三(63%)曾在生活中的某个时刻认真考虑过自杀的慢性疼痛患者已经没有这些想法了。那些没有自杀意念的人更有可能年龄较大、女性、白人、受教育程度较高、有知己,并且更倾向于利用精神信仰来应对困难,但他们不太可能收入低、难以维持基本生活费用,也不太可能有抑郁和焦虑障碍的病史。观点:过去一年中,近三分之二有慢性疼痛且曾有过自杀想法的加拿大患者已不再有自杀念头。这些发现提供了一个在致残性疼痛背景下具有韧性和康复的希望信息,并有助于改善对那些最容易出现持续自杀意念的人的针对性外联。

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