Primary Care and Mental Health, University of Liverpool, Liverpool, UK
Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, Merseyside, UK.
BMJ Open. 2021 Feb 4;11(2):e035252. doi: 10.1136/bmjopen-2019-035252.
To address a gap in knowledge by simultaneously assessing a broad spectrum of individual socioeconomic and potential health determinants of suicidal ideation (SI) using validated measures in a large UK representative community sample.
In this cross-sectional design, participants were recruited via random area probability sampling to participate in a comprehensive public health survey. The questionnaire examined demographic, health and socioeconomic factors. Logistic regression analysis was employed to identify predictors of SI.
Community setting from high (n=20) and low (n=8) deprivation neighbourhoods across the North West of England, UK.
4319 people were recruited between August 2015 and January 2016. There were 809 participants from low-deprivation neighbourhoods and 3510 from high-deprivation neighbourhoods. The sample comprised 1854 (43%) men and 2465 (57%) women.
SI was the dependent variable which was assessed using item 9 of the Patient Health Questionnaire-9 instrument.
454 (11%) participants reported having SI within the last 2 weeks. Model 1 (excluding mental health variables) identified younger age, black and minority ethnic (BME) background, lower housing quality and current smoker status as key predictors of SI. Higher self-esteem, empathy and neighbourhood belonging, alcohol abstinence and having arthritis were protective against SI. Model 2 (including mental health variables) found depression and having cancer as key health predictors for SI, while identifying as lesbian, gay, bisexual, transgender or queer (LGBTQ) and BME were significant demographic predictors. Alcohol abstinence, having arthritis and higher empathy levels were protective against SI.
This study suggests that it could be useful to increase community support and sense of belonging using a public health approach for vulnerable groups (e.g. those with cancer) and peer support for people who identify as LGBTQ and/or BME. Also, interventions aimed at increasing empathic functioning may prove effective for reducing SI.
通过在英国具有代表性的社区大样本中使用经过验证的测量工具，同时评估自杀意念（SI）的广泛个体社会经济和潜在健康决定因素，以填补知识空白。
在这项横断面设计中，通过随机区域概率抽样招募参与者参加全面的公共卫生调查。问卷检查了人口统计学、健康和社会经济因素。采用逻辑回归分析确定 SI 的预测因素。
来自英国西北部高（n=20）和低（n=8）贫困社区的社区环境。
2015 年 8 月至 2016 年 1 月期间共招募了 4319 人。低贫困社区有 809 名参与者，高贫困社区有 3510 名参与者。样本包括 1854 名（43%）男性和 2465 名（57%）女性。
SI 是因变量，使用患者健康问卷-9 仪器的第 9 项进行评估。
454 名（11%）参与者报告在过去 2 周内有 SI。模型 1（不包括心理健康变量）确定年龄较小、黑人或少数族裔（BME）背景、较低的住房质量和当前吸烟者状态是 SI 的主要预测因素。较高的自尊心、同理心和社区归属感、戒酒和患关节炎可预防 SI。模型 2（包括心理健康变量）发现抑郁和患有癌症是 SI 的关键健康预测因素，同时确定为女同性恋、男同性恋、双性恋、跨性别或酷儿（LGBTQ）和 BME 是重要的人口统计学预测因素。戒酒、患关节炎和较高的同理心水平可预防 SI。
这项研究表明，使用公共卫生方法为弱势群体（例如患有癌症的人）增加社区支持和归属感，以及为 LGBTQ 和/或 BME 认同者提供同伴支持，可能会有所帮助。此外，旨在增强同理心功能的干预措施可能对减少 SI 有效。
