VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States.
VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States.
Psychiatry Res. 2019 Jun;276:250-261. doi: 10.1016/j.psychres.2019.05.019. Epub 2019 May 10.
Suicide is a significant public health problem associated with numerous health factors such as insomnia. Suicidal ideation is common among veterans, who often present with multiple comorbidities. The present study examined direct and indirect relationships among suicidal ideation, insomnia, depression, and alcohol use. U.S. veterans (n = 850) recently separated from military service completed phone-based interviews covering multiple domains. Tests of indirect effects and bias-corrected confidence intervals were used to conduct a cross-sectional analysis of baseline data from a larger parent study examining relationships among the latent variables of suicidal ideation, insomnia, alcohol use, and depression. In this analysis insomnia did not have direct associations with suicidal ideation (Β = 0.06, t = 0.29, p = .772) or alcohol use (Β = 0.07, t = 1.73, p = .084). Insomnia severity was, however, significantly and positively related to depression severity (Β = 0.58, t = 21.70, p < .001). Additionally, more severe depression was associated with greater intensity of suicidal ideation (Β = 0.59, t = 3.64, p < .001). Notably, insomnia's indirect effect on suicidal ideation was driven by depression. In this sample of returning veterans, insomnia appears to indirectly impact suicidal ideation through its relationship with depression. This finding suggests the potential utility of addressing insomnia as part of an overall approach to reducing depressive symptomatology and indirectly, suicidal ideation.
自杀是一个与众多健康因素相关的重大公共卫生问题，如失眠。自杀意念在退伍军人中很常见，他们通常伴有多种共病。本研究考察了自杀意念、失眠、抑郁和饮酒之间的直接和间接关系。最近从军队退伍的美国退伍军人（n=850）完成了涵盖多个领域的电话访谈。使用间接效应和偏置校正置信区间测试对一项更大的母研究中自杀意念、失眠、饮酒和抑郁等潜在变量之间关系的基线数据进行了横断面分析。在这项分析中，失眠与自杀意念（Β=0.06，t=0.29，p=0.772）或饮酒（Β=0.07，t=1.73，p=0.084）没有直接关联。然而，失眠严重程度与抑郁严重程度呈显著正相关（Β=0.58，t=21.70，p<0.001）。此外，更严重的抑郁与更强的自杀意念强度相关（Β=0.59，t=3.64，p<0.001）。值得注意的是，失眠对自杀意念的间接影响是由抑郁驱动的。在这个返回的退伍军人样本中，失眠似乎通过与抑郁的关系间接影响自杀意念。这一发现表明，解决失眠问题作为降低抑郁症状和间接降低自杀意念的整体方法的一部分具有潜在的效用。
