中国山东高血压患者的自杀意念：路径分析。
Suicidal ideation among the hypertensive individuals in Shandong, China: a path analysis.
机构信息
School of Public Health, Shandong University, Jinan, 250012, China.
Shandong Center for Disease Control and Prevention, Jinan, China.
出版信息
BMC Psychiatry. 2019 Sep 2;19(1):266. doi: 10.1186/s12888-019-2256-7.
BACKGROUND
Although massive studies have explored the risk factors of suicidal ideation (SI), the prevalence of SI and its associated factors in the hypertensive individuals are largely unknown. This study aims to investigate the factors associated with SI in the hypertensive individuals.
METHODS
Three thousand nine hundred eleven hypertensive individuals in Shandong, China were included in the analysis. SI was assessed by using a question from the NCS (National Comorbidity Survey). We used binary logistic regression analysis to explore the factors associated with SI, and path analysis to test the direct and indirect relationships between associated factors and SI among hypertensive patients.
RESULTS
The prevalence of SI in the hypertensive individual was19.6%. Psychological distress had the greatest direct (β = 0.640, p-value <0.01) and total effect (β = 0.640, p-value <0.01) on SI. Other factors including comorbidity (β = 0.090, p-value <0.01), gender (β = 0.088, p-value <0.01), marital status (β = - 0.037, p-value <0.01), economic status (β = - 0.106, p-value <0.01), residence (β = - 0.050, p-value <0.01), alcohol use (β = 0.011, p-value <0.01), exercise (β = - 0.114, p-value <0.01), hospitalization (β = 0.041, p-value <0.01) only had indirect effects on SI. Psychological distress was a mediator between SI and those variables.
CONCLUSION
A significant mediation effect of psychological distress on the associations between SI and some associated factors (i.e., economic status, comorbidity) was demonstrated.
背景
尽管大量研究探讨了自杀意念（SI）的风险因素，但高血压患者中 SI 的患病率及其相关因素在很大程度上仍不清楚。本研究旨在探讨与高血压患者 SI 相关的因素。
方法
本研究纳入了中国山东的 3911 名高血压患者。使用 NCS（国家共病调查）中的一个问题评估 SI。我们使用二元逻辑回归分析探讨与 SI 相关的因素，并进行路径分析以检验高血压患者中相关因素与 SI 之间的直接和间接关系。
结果
高血压患者中 SI 的患病率为 19.6%。心理困扰对 SI 具有最大的直接（β=0.640，p 值<0.01）和总效应（β=0.640，p 值<0.01）。其他因素包括共病（β=0.090，p 值<0.01）、性别（β=0.088，p 值<0.01）、婚姻状况（β=-0.037，p 值<0.01）、经济状况（β=-0.106，p 值<0.01）、居住地（β=-0.050，p 值<0.01）、饮酒（β=0.011，p 值<0.01）、锻炼（β=-0.114，p 值<0.01）、住院（β=0.041，p 值<0.01）仅对 SI 具有间接影响。心理困扰是 SI 与这些变量之间的中介变量。
结论
心理困扰在 SI 与某些相关因素（即经济状况、共病）之间的关联中表现出显著的中介效应。
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