Kielan Aleksandra, Jaworski Mariusz, Mosiołek Anna, Chodkiewicz Jan, Święcicki Łukasz, Walewska-Zielecka Bożena
Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.
Polish Suicidological Association, Warsaw, Poland.
Front Psychiatry. 2021 Jun 23;12:644097. doi: 10.3389/fpsyt.2021.644097. eCollection 2021.
Depression is the most common psychiatric disorder in people who die by suicide. Awareness of risk factors for suicide in depression is important for clinicians. The study was aimed at establishing models of factors related to the level of depression and suicidal behavior among men from three different groups-in men with depressive disorder, in comparison to men with physical disorder and healthy men. A total of 598 men were included in the study. The following questionnaires were used in research model: test with sociodemographic variables, AUDIT Test, Fagerström Test, Generalized Self-Efficacy Scale (GSES), Inventory for Measuring Coping with Stress (Mini-COPE), Resilience Evaluation Questionnaire (KOP-26), Suicide Behaviors Questionnaire-Revised (SBQ-R) by Osman, and Gotland Male Depression Scale. In men with depression, the positive factors strongly related to the intensity of depression and suicidal behavior were as follows: vocational education, active coping, turning toward religion, social competence for resilience, and bachelor status. The factors negatively related to the intensity of depression and suicidal behavior in this group were as follows: unemployed status, student status, low satisfaction with the financial situation, having children, history of mental disorders in family, alcohol addiction, and seeking instrumental support. In the group of men with physical disorders, the following protection factors were identified: the medium or small city as a place of living, active coping, venting, and personal competence. The following risk factors were identified in this group: psychiatric treatment in the past. In the group of healthy men, the following protective factors were identified: the medium city as a place of living, positive reappraisal, planning abilities, and personal and social competence for resilience. In this group, the following risk factors were identified: vocational and higher education, student status, satisfaction with the financial situation, having more than one children, the occurrence of mental disorders in the family, the occurrence of alcohol abuse in the family, and use of psychoactive substances as a strategy of dealing with stress. The risk factors identified in this study should be included in the clinical assessment of depression and suicidal behavior risk in male patients. There are some protective factors identified, including productive coping and personal and social competencies, which can be developed and should be especially considered and strengthened in mental health promotion programs aimed at men.
抑郁症是自杀身亡者中最常见的精神障碍。了解抑郁症患者自杀的风险因素对临床医生很重要。该研究旨在建立与来自三个不同组别的男性的抑郁程度和自杀行为相关的因素模型——与患有躯体疾病的男性和健康男性相比,患有抑郁症的男性。共有598名男性纳入该研究。研究模型中使用了以下问卷:社会人口统计学变量测试、酒精使用障碍识别测试(AUDIT Test)、法格斯特龙测试(Fagerström Test)、一般自我效能量表(GSES)、应对压力测量量表(Mini - COPE)、复原力评估问卷(KOP - 26)、奥斯曼修订的自杀行为问卷(SBQ - R)以及哥特兰男性抑郁量表。在患有抑郁症的男性中,与抑郁强度和自杀行为密切相关的积极因素如下:职业教育、积极应对、求助宗教、具备复原力的社会能力以及单身状态。该组中与抑郁强度和自杀行为呈负相关的因素如下:失业状态、学生身份、对财务状况满意度低、有子女、家族精神病史、酒精成瘾以及寻求工具性支持。在患有躯体疾病的男性组中,确定了以下保护因素:居住在中小城市、积极应对、宣泄以及个人能力。在该组中确定了以下风险因素:过去接受过精神科治疗。在健康男性组中,确定了以下保护因素:居住在中等城市、积极重新评价、规划能力以及具备复原力的个人和社会能力。在该组中确定了以下风险因素:职业教育和高等教育、学生身份、对财务状况满意、有多个子女、家族中出现精神障碍、家族中出现酒精滥用以及使用精神活性物质作为应对压力的策略。本研究中确定的风险因素应纳入男性患者抑郁和自杀行为风险的临床评估。还确定了一些保护因素,包括有效的应对方式以及个人和社会能力,这些因素可以得到培养,并且在针对男性的心理健康促进项目中应特别予以考虑和加强。