Elbogen Eric B, Lanier Megan, Blakey Shannon M, Wagner H Ryan, Tsai Jack
Department of Veterans Affairs, National Center on Homelessness Among Veterans, Tampa, Florida, USA.
VISN 6 Mental Illness Research, Education, and Clinical Center (MIRECC), Durham VA Health Care System, Durham, North Carolina, USA.
Depress Anxiety. 2021 May 5;38(7):739-48. doi: 10.1002/da.23162.
There are significant concerns about mental health problems occurring due to the coronavirus disease 2019 (COVID-19) pandemic. To date, there has been limited empirical investigation about thoughts of suicide and self-harm during the COVID-19 pandemic.
A national survey was conducted May 2020 to investigate the association between mental health symptoms, social isolation, and financial stressors during the COVID-19 pandemic and thoughts of suicide and self-harm. A total of 6607 US adults completed an online survey; survey criteria included an age minimum of 22 years old and reported annual gross income of $75,000 or below. Statistical raking procedures were conducted to more precisely weight the sample using US Census data on age, geographic region, sex, race, and ethnicity.
COVID-19-related stress symptoms, loneliness, and financial strain were associated with thoughts of suicide/self-harm in multivariable logistic regression analyses, as were younger age, being a military veteran, past homelessness, lifetime severe mental illness, current depressive symptoms, alcohol misuse, and having tested positive for COVID-19. Greater social support was inversely related to thoughts of suicide/self-harm whereas running out of money for basic needs (e.g., food), housing instability (e.g., delaying rent), and filing for unemployment or disability were positively related.
Public health interventions to decrease risk of suicide and self-harm in the wake of the COVID-19 pandemic should address pandemic-related stress, social isolation, and financial strain experienced including food insecurity, job loss, and risk of eviction/homelessness.
人们对2019冠状病毒病(COVID-19)大流行引发的心理健康问题深感担忧。迄今为止,关于COVID-19大流行期间自杀和自我伤害念头的实证研究有限。
2020年5月进行了一项全国性调查,以研究COVID-19大流行期间心理健康症状、社会隔离和经济压力源与自杀和自我伤害念头之间的关联。共有6607名美国成年人完成了一项在线调查;调查标准包括年龄至少22岁且报告的年度总收入为75,000美元或以下。使用美国人口普查关于年龄、地理区域、性别、种族和民族的数据进行统计加权程序,以更精确地对样本进行加权。
在多变量逻辑回归分析中,与COVID-19相关的压力症状、孤独感和经济压力与自杀/自我伤害念头相关,年轻、退伍军人、过去无家可归、终生严重精神疾病、当前抑郁症状、酒精滥用以及COVID-19检测呈阳性也与自杀/自我伤害念头相关。更大的社会支持与自杀/自我伤害念头呈负相关,而基本需求(如食物)资金短缺、住房不稳定(如延迟支付租金)以及申请失业或残疾与自杀/自我伤害念头呈正相关。
在COVID-19大流行后,降低自杀和自我伤害风险的公共卫生干预措施应解决与大流行相关的压力、社会隔离以及所经历的经济压力,包括粮食不安全、失业以及被驱逐/无家可归的风险。