自杀倾向与无家可归的发生：来自 VA 治疗记录的时间关联证据。
Suicidality and the Onset of Homelessness: Evidence for a Temporal Association From VHA Treatment Records.
机构信息
School of Social Policy and Practice, University of Pennsylvania, Philadelphia (Culhane); National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Washington, D.C. (Szymkowiak); School of Aging Studies, University of South Florida, Tampa (Schinka).
出版信息
Psychiatr Serv. 2019 Nov 1;70(11):1049-1052. doi: 10.1176/appi.ps.201800415. Epub 2019 Jul 24.
OBJECTIVE
This study examined the temporal sequencing of a first-recorded episode of homelessness and treatment for suicidal ideation or attempt.
METHODS
Data were from the U.S. Department of Veterans Affairs Corporate Data Warehouse and contained medical records of service use dates and associated codes for care provided by the Veterans Health Administration. The analysis examined treatment for suicidality before and after a first record of homelessness ("onset") among 152,519 veterans. The second analysis examined the rate of treatment for suicidality among 156,288 veterans with any indication of homelessness. The third analysis examined the rate of homelessness among 145,770 veterans with indication of suicidality.
RESULTS
Among newly homeless veterans, treatment for suicidality peaked just before onset of homelessness. Thirteen percent of homeless veterans had evidence of suicidality. Twenty-nine percent of veterans with evidence of suicidality appeared to have concurrent homelessness.
CONCLUSIONS
Homelessness should be considered a primary risk factor for suicidality.
目的
本研究探讨了首次无家可归记录和自杀意念或尝试治疗之间的时间顺序。
方法
数据来自美国退伍军人事务部公司数据仓库，包含退伍军人健康管理局提供的服务使用日期和相关代码的医疗记录。该分析在 152519 名退伍军人中，检查了首次记录无家可归（“发病”）之前和之后自杀意念治疗情况。第二项分析检查了在有任何无家可归迹象的 156288 名退伍军人中，治疗自杀意念的比率。第三项分析检查了在有自杀迹象的 145770 名退伍军人中，无家可归的比率。
结果
在新无家可归的退伍军人中，自杀意念治疗在无家可归发病前达到高峰。13%的无家可归退伍军人有自杀意念的迹象。有自杀意念迹象的退伍军人中，有 29%似乎同时存在无家可归现象。
结论
无家可归应被视为自杀意念的主要风险因素。
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