Sunderland Matthew, Batterham Philip J, Calear Alison L, Chapman Cath, Slade Tim
The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, Australia.
Centre for Mental Health Research, Research School of Population Health, the Australian National University, Canberra, Australia.
Psychol Med. 2023 Jan;53(1):258-266. doi: 10.1017/S0033291721001501. Epub 2021 Apr 30.
Suicide plans and attempts rarely occur without prior suicidal ideation but are hard to predict. Early intervention efforts need to focus on subgroups of the population who are more likely to transition from ideation to suicidal plans and attempts. The current study utilised data from a large nationally representative sample to investigate the time taken to transition and the demographic and mental health correlates of transitioning to suicidal plans and attempts among those with suicidal ideation.
Data were from 1237 Australians aged 16-85 years who reported suicidal thoughts at some point in their life. Discrete time survival analysis was used to retrospectively examine the time in years and correlates of transitioning from suicidal ideation to suicide plans and suicide attempt.
The majority of those who transitioned to suicide plans or attempts typically did so within 2 years of first experiencing suicidal ideation. Several factors were independently associated with increased speed to transition, including alcohol use disorder, drug use disorder, major depressive episode, obsessive compulsive disorder, sexual minority status, and non-urban location. Older age, being male, older age of first ideation and greater family support were associated with a slower transition.
The current study suggests that pre-existing mental or substance use disorders, particularly drug use disorder, as well as sexual minority status, sex and greater family support play an important role in the transition from suicidal ideation to plans or attempts. These results highlight the potential importance of suicide prevention programs that aim to improve social connectedness.
自杀计划和自杀未遂很少在没有先前自杀意念的情况下发生，但却难以预测。早期干预措施需要聚焦于更有可能从意念转变为自杀计划和自杀未遂的人群亚组。本研究利用来自一个具有全国代表性的大样本数据，调查了转变所需的时间，以及有自杀意念者转变为自杀计划和自杀未遂的人口统计学和心理健康相关因素。
数据来自1237名年龄在16 - 85岁之间、在人生某个阶段报告有自杀想法的澳大利亚人。采用离散时间生存分析回顾性地研究从自杀意念转变为自杀计划和自杀未遂的年数及相关因素。
大多数转变为自杀计划或自杀未遂的人通常是在首次出现自杀意念后的2年内这样做的。几个因素与更快的转变速度独立相关，包括酒精使用障碍、药物使用障碍、重度抑郁发作、强迫症、性少数群体身份以及非城市地区。年龄较大、男性、首次出现意念时年龄较大以及家庭支持较多与较慢的转变相关。
当前研究表明，先前存在的精神或物质使用障碍，尤其是药物使用障碍，以及性少数群体身份、性别和更多的家庭支持在从自杀意念转变为计划或未遂方面起着重要作用。这些结果凸显了旨在改善社会联系的自杀预防项目的潜在重要性。
