Health and Behavior Postgraduate Program, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil.
Compr Psychiatry. 2020 Oct;102:152194. doi: 10.1016/j.comppsych.2020.152194. Epub 2020 Jul 16.
Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality.
In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview.
Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality.
We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up.
MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.
在中低收入国家，关于精神障碍的患病率和共病性（包括自杀倾向）的研究很少。本研究旨在描述精神障碍的共病模式及其与自杀倾向的关系。
1982 年，我们对巴西南部皮拉塔斯（Pelotas）所有的医院分娩情况进行了识别（n=5914），并对其进行了前瞻性随访。在 18-19 岁、23 岁和 30 岁时，参与者的常见精神障碍（CMD）情况由经过培训的心理学家使用 Mini International Neuropsychiatric Interview 进行评估。
自杀愿望、自杀计划和终生自杀尝试的发生率分别为 4.9%、3.8%和 6.6%。自杀愿望与同时患有重度抑郁发作（MD）和终生自杀尝试的关联最强（OR=26.4，95%CI：13.9-50.4），与 MD 伴轻躁狂/躁狂的关联次之（OR=21.2，95%CI：6.93-65.1）。自杀计划与同时患有 MD 和终生自杀尝试的关联最强（OR=44.7，95%CI：22.6-88.4），与 MD 伴社交焦虑障碍的关联次之（OR=30.6，95%CI：13.0-72.0），与同时患有社交焦虑障碍和终生自杀尝试的关联再次之（OR=26.3，95%CI：8.33-82.7）。CMD 的前瞻性和横断面测量指标与较高的自杀率独立相关，与其他障碍无关。
我们在随访中没有自杀死亡的数据，且在 30 岁时使用的诊断工具并非在所有先前的随访中都使用。
MD 和社交焦虑症与自杀倾向有独立和共同的关联，而且还与终生自杀尝试和其他精神障碍有关。
