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艾滋病治疗中心的自杀预防:治疗常见精神障碍的人群归因风险分析

Suicide Prevention in HIV Treatment Centres: Population Attributable Risk Analysis of Treating Common Mental Disorders.

作者信息

Bantjes Jason, Kagee Ashraf

机构信息

Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.

Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.

出版信息

AIDS Behav. 2021 Jun;25(6):1864-1872. doi: 10.1007/s10461-020-03116-5. Epub 2021 Jan 2.

Abstract

The aim was to establish the potential reduction in non-fatal suicidal behaviour (NFSB) that could be achieved by treating common mental disorders (CMDs) among persons receiving HIV treatment. Data were collected from antiretroviral therapy (ART) patients in South Africa (n = 688). Structured Clinical Interviews assessed CMDs and the Mini International Neuropsychiatric Interview assessed 1-month prevalence of NFSB and suicide risk. Population Attributable Risk (PAR) analysis established the potential reduction in prevalence of NFSB and suicide risk that could be achieved by treating CMDs, with the simplifying assumption of a causal relationship between psychopathology and suicidality. Treating CMDs could result in as much as a 63.9% proportional reduction in the prevalence of suicide ideation, 84.2% proportional reduction in the prevalence of suicide plan, and 63.4% proportional decrease in prevalence of suicide risk. There is potential to significantly reduce NFSB among ART patients. Pragmatic trials are needed to evaluate the effects of treating CMDs in HIV treatment centres.

摘要

目的是确定通过治疗接受艾滋病毒治疗者中的常见精神障碍(CMD)可实现的非致命自杀行为(NFSB)的潜在减少情况。数据收集自南非的抗逆转录病毒疗法(ART)患者(n = 688)。结构化临床访谈评估CMD,迷你国际神经精神访谈评估NFSB的1个月患病率和自杀风险。人群归因风险(PAR)分析确定了通过治疗CMD可实现的NFSB患病率和自杀风险的潜在降低,简化假设为精神病理学与自杀行为之间存在因果关系。治疗CMD可使自杀意念患病率比例降低多达63.9%,自杀计划患病率比例降低84.2%,自杀风险患病率比例降低63.4%。在ART患者中显著降低NFSB具有潜力。需要进行务实试验以评估在艾滋病毒治疗中心治疗CMD的效果。

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