School of Psychology, South China Normal University, Guangzhou, Guangdong, China.
Department of Psychology, Lund University, Lund221 00, Sweden.
Epidemiol Psychiatr Sci. 2020 Oct 19;29:e175. doi: 10.1017/S2045796020000827.
Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood.
A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions.
Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans.
The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.
先前关于抑郁症状和自杀倾向（自杀意念、计划和尝试）之间关联的研究通常采用变量为中心的方法，而没有考虑到抑郁症状随时间变化的个体差异。通过对暴露于 2008 年汶川地震的一大群中国青少年进行 10 年随访，本研究检验了在地震后早期阶段抑郁症状的个体差异是否会导致年轻人在成年期产生不同的自杀倾向结果。
共有 1357 名暴露于汶川地震的中国青少年在地震后 6、18 和 30 个月时接受了抑郁症状和其他变量的调查。共有 799 名参与者对 10 年随访做出了回应，并完成了一项涵盖自杀倾向和其他变量的在线调查。分析样本为 744 名有抑郁症状和自杀倾向有效数据的参与者。使用逻辑回归分析数据。
发现 10 年后过去一年自杀意念、自杀计划和自杀尝试的患病率估计分别为 10.8%、7.3%和 3.0%。抑郁症状分为 5 种轨迹：抵抗（54.4%）、慢性（13.3%）、恢复（10.4%）、延迟功能障碍（12.0%）和复发/缓解（10.0%）。在控制了协变量后，全样本回归显示，只有复发/缓解的抑郁轨迹仍然与自杀倾向显著相关。此外，慢性组中的男性而非女性更有可能有自杀计划。
这些发现强调了检测具有不同心理状态轨迹的灾难幸存者的重要性，并为他们提供个性化和有效的心理健康服务，以降低他们未来的自杀倾向风险。
