Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Korea Psychological Autopsy Center (KPAC), Seoul, South Korea; Department of Psychiatry, Keyo Hospital, Uiwang, South Korea.
Korea Psychological Autopsy Center (KPAC), Seoul, South Korea.
J Affect Disord. 2020 Jul 1;272:423-431. doi: 10.1016/j.jad.2020.04.021. Epub 2020 May 3.
Suicide survivors are defined as victims who experienced suicide of siblings or parents, spouses, or lineal relatives within the fourth degree who had lived with them. We compared the effects of major depressive disorder (MDD), symptoms of posttraumatic stress disorder (PTSD), and impulsivity on lifetime suicide attempts among suicide survivors.
Participants included 272 suicide survivors. We compared them to 5,200 members from the general population who were matched by age, sex, and years of education. We evaluated participants using the Patient Health Questionnaire-9 (PHQ-9), the EuroQuality of Life (EuroQol) scale, the Impact of Events Scale-Revised (IES-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Composite International Diagnostic Interview (K-CIDI).
Among the 272 suicide survivors, MDD was nine times higher (47.1% vs. 5.3%), and suicidal attempts were six times higher (20.5% vs. 3.3%) than reported among the general population. The suicide survivors showed more severe depression, greater impulsivity, and poorer quality of life than did the general population. In multivariate logistic regression analyses performed to evaluate each IES-R item, "trouble staying asleep" was the only PTSD symptom item that was significantly associated with suicide attempts among suicide survivors. Suicide survivors who had both MDD with insomnia and high impulsivity were at four times higher risk for suicide attempts than the general population with no MDD (AOR = 4.04, 95% CI: 1.25-13.09).
Surviving suicide by family members is an important risk factor for suicide attempts. In particular, MDD with insomnia and impulsivity are associated with suicide attempts among suicide survivors.
自杀幸存者是指经历过兄弟姐妹或父母、配偶或直系亲属自杀，并与他们共同生活的受害者。我们比较了重度抑郁症（MDD）、创伤后应激障碍（PTSD）症状和冲动性对自杀幸存者一生中自杀企图的影响。
参与者包括 272 名自杀幸存者。我们将他们与通过年龄、性别和受教育年限相匹配的 5200 名普通人群成员进行比较。我们使用患者健康问卷-9（PHQ-9）、欧洲生活质量（EuroQol）量表、修订后的事件影响量表（IES-R）、巴雷特冲动量表-11（BIS-11）和复合国际诊断访谈（K-CIDI）评估参与者。
在 272 名自杀幸存者中，MDD 发生率高 9 倍（47.1% vs. 5.3%），自杀企图发生率高 6 倍（20.5% vs. 3.3%）。与普通人群相比，自杀幸存者表现出更严重的抑郁、更高的冲动性和更差的生活质量。在评估每个 IES-R 项目的多元逻辑回归分析中，“难以入睡”是唯一与自杀幸存者自杀企图显著相关的 PTSD 症状项目。与普通人群相比，同时患有失眠和高冲动性的 MDD 自杀幸存者自杀企图的风险高 4 倍（AOR=4.04，95%CI：1.25-13.09）。
家庭成员的自杀幸存是自杀企图的一个重要危险因素。特别是失眠和冲动性的 MDD 与自杀幸存者的自杀企图有关。
