Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen Wai, Beijing 100069, China.
Capital Medical University Affiliated Beijing Anding Hospital, Beijing, China.
J Affect Disord. 2021 Aug 1;291:344-351. doi: 10.1016/j.jad.2021.05.033. Epub 2021 May 27.
Suicide is a major but preventable public health problem in the world. Mental disorders are related to suicide, and can predict suicidal ideation (SI). This study aims to compare the differences in the prevalence and risk factors of SI among patients with five types of mental disorders.
This study involved adult inpatients with five types of mental disorders in Beijing Anding Hospital. Text mining was used to extract information from the electronic medical records. We performed the Pearson's Chi-square analysis and multivariable unconditional logistic regression to filter factors to assess odds of SI for each type of mental disorders.
Of the 21,287 participants included, 2,619 had experienced SI. For both sexes, the highest risk of SI was found for patients with recurrent depressive disorder (OR = 7.096; P <.001), followed by patients with depressive episode and bipolar affective disorder when comparing with those with substance use disorder. Gender, age, occupation, drinking, single child, personal relationship, family history of mental disorder, family history of suicide and psychological trauma were associated with SI after adjusting for confounding factors, but the risk factors and their effects in each type were different.
The clear causal associations between mental disorders and SI cannot be elucidated. In addition, the ability to study the predictors of SI is constrained by the fact that the sample excluded people who completed suicide.
SI is common and distinct strategies should be taken in suicide prevention for patients with different types of mental disorders.
自杀是全球一个重大但可预防的公共卫生问题。精神障碍与自杀有关，并可预测自杀意念（SI）。本研究旨在比较五种精神障碍患者中 SI 的患病率和危险因素的差异。
本研究纳入了北京安定医院的五种类型精神障碍的成年住院患者。采用文本挖掘技术从电子病历中提取信息。我们进行了 Pearson's Chi-square 分析和多变量非条件逻辑回归，以筛选因素来评估每种精神障碍发生 SI 的几率。
在 21287 名参与者中，有 2619 名经历过 SI。对于男性和女性，复发性抑郁障碍患者的 SI 风险最高（OR=7.096；P<.001），与物质使用障碍患者相比，抑郁发作和双相情感障碍患者的 SI 风险更高。在调整混杂因素后，性别、年龄、职业、饮酒、独生子女、人际关系、精神障碍家族史、自杀家族史和心理创伤与 SI 相关，但每种类型的危险因素及其作用不同。
精神障碍和 SI 之间的明确因果关系无法阐明。此外，由于样本排除了自杀的人，因此研究 SI 预测因素的能力受到限制。
SI 很常见，对于不同类型的精神障碍患者，应采取不同的预防自杀策略。
