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埃塞俄比亚结核病患者的自杀意念、自杀未遂及相关因素:一项横断面研究

Suicidal Ideation, Attempt, and Associated Factors among Patients with Tuberculosis in Ethiopia: A Cross-Sectional Study.

作者信息

Molla Alemayehu, Mengesha Atikilt, Derajew Habtamu, Kerebih Habtamu

机构信息

Department of Psychiatry, College of Health Science, Dilla University, Dilla, Ethiopia.

Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

出版信息

Psychiatry J. 2019 Mar 13;2019:4149806. doi: 10.1155/2019/4149806. eCollection 2019.

Abstract

BACKGROUND

Suicidal behaviors among people with tuberculosis are one of the commonest psychiatric emergencies that need a major public health concern. People with tuberculosis show suicidal ideation and attempt, which are problems to end life. In Ethiopia large numbers of people are affected by tuberculosis. Therefore, assessing suicide among patients with tuberculosis is important in implementing further interventions.

METHODS

An institutional based cross-sectional study was conducted among systematic random samples of 415 and face-to-face interview was used. Suicidal ideation and attempt were assessed by using suicidality module World Health Organization (WHO) composite International diagnostic interview (CIDI). Data was analyzed by using SPSS version 20. Bivariate and multivariate binary logistic analyses were done to identify associated factors to both suicidal ideation and attempt. P values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% C.I.

RESULTS

The prevalence of suicidal ideation and attempt among tuberculosis patients was 17.3% (95%CI, 13.7-20.6) and 7.5 %( 95%CI, 4.8-10.4), respectively. Being female (AOR=2.7, 95% CI 1.39, 5.23), no formal education (AOR=3.35, 95%CI 1.26, 9.91), extra-pulmonary tuberculosis (AOR=2.35, 95%CI 1.1, 4.98), depression (AOR=4.9, 95%CI, 2.56, 9.4), and perceived TB stigma (AOR=3.24, 95%CI, 1.64, 6.45) were statistically associated with suicidal ideation. Factors like being female (AOR=4.57, 95%CI, 1.7, 12.27), MDR-TB (AOR=3.06, 95%CI, 1.23, 7.57), comorbid HIV illness (AOR=6.67, 95%CI, 2.24, 19.94), and depression (AOR=4.75, 95%CI, 1.89, 11.91) were associated with suicidal attempt.

CONCLUSION

Developing guidelines and training of health workers in TB clinics is important to screen and treat suicide among patients with tuberculosis.

摘要

背景

结核病患者的自杀行为是最常见的精神科急症之一,需要引起重大公共卫生关注。结核病患者存在自杀意念和自杀企图,这些都是危及生命的问题。在埃塞俄比亚,大量人群受到结核病影响。因此,评估结核病患者的自杀情况对于实施进一步干预措施很重要。

方法

在415名系统随机抽样患者中开展了一项基于机构的横断面研究,并采用面对面访谈。使用世界卫生组织(WHO)综合国际诊断访谈(CIDI)的自杀模块评估自杀意念和自杀企图。数据采用SPSS 20版进行分析。进行双变量和多变量二元逻辑分析以确定与自杀意念和自杀企图相关的因素。P值小于0.05被认为具有统计学意义,关联强度通过调整后的比值比及95%置信区间表示。

结果

结核病患者中自杀意念和自杀企图的患病率分别为17.3%(95%CI,13.7 - 20.6)和7.5%(95%CI,4.8 - 10.4)。女性(调整后比值比=2.7,95%CI 1.39,5.23)、未接受正规教育(调整后比值比=3.35,95%CI 1.26,9.91)、肺外结核(调整后比值比=2.35,95%CI 1.1,4.98)、抑郁(调整后比值比=4.9,95%CI,2.56,9.4)以及感知到的结核病耻辱感(调整后比值比=3.24,95%CI,1.64,6.45)与自杀意念在统计学上相关。女性(调整后比值比=4.57,95%CI,1.7,12.27)、耐多药结核病(调整后比值比=3.06,95%CI,1.23,7.57)、合并艾滋病毒感染(调整后比值比=6.67,95%CI,2.24,19.94)以及抑郁(调整后比值比=4.75,95%CI,1.89,11.91)等因素与自杀企图相关。

结论

制定指南并对结核病诊所的医护人员进行培训对于筛查和治疗结核病患者的自杀情况很重要。

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