Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico.
Dept. of Health Sciences, Institute for Health Equity & Social Justice Research, Northeastern University, Boston, MA, USA.
J Psychiatr Res. 2021 Oct;142:171-178. doi: 10.1016/j.jpsychires.2021.08.001. Epub 2021 Aug 2.
Limited research exists on the impact of type and number of traumatic events on the incidence of suicide ideation and attempts (suicidality) among adolescents in low/middle income countries where violence is common.
We estimated prospective associations of 7 types of events on the new occurrence of suicidality from a follow-up conducted in 2013 (n = 1071; ages 19-26) of the original Mexican Adolescent Mental Health Survey conducted in 2005 (ages 12-17), by using Hazard Ratios (HR) estimates.
For new onset of suicide ideation, those reporting "Ever raped or sexually assaulted" had the highest adjusted HR (3.8), followed by "Ever other traumatic event" (HR = 1.9), "Ever committed or witnessed violence" (HR = 1.7) and "Beaten as a child or witnessed physical fights at home" (HR = 1.5). For suicide attempt, those reporting "Ever beaten up by spouse, partner, someone else, mugged with a weapon, or stalked" (HR = 3.8) and "Ever other traumatic event" (HR = 2.0) had the higher hazards. Compared to those without a traumatic event, increased hazards of ideation and attempt were found for those reporting a greater number of types of events.
Our sample is representative of the largest metropolitan area in Mexico but does not include other cities or age groups that may differ in risk factors. Traumatic events that happened in the eight years between waves are not considered. Traumatic events increased the risk of suicidality, independent of common mental disorders. Identifying and addressing these events in clinical settings may therefore be important for preventing suicide in this population.
在暴力事件常见的中低收入国家,关于创伤事件的类型和数量对青少年自杀意念和自杀企图(自杀行为)发生率的影响,相关研究有限。
我们利用 2005 年开展的墨西哥青少年心理健康调查(年龄 12-17 岁)的后续随访数据(n=1071;年龄 19-26 岁),通过危害比(HR)估计值,估算了 7 种类型的事件与新发生自杀行为之间的前瞻性关联。
对于自杀意念的新发,报告“曾遭受强奸或性侵犯”的个体具有最高的调整后 HR(3.8),其次是“曾遭受其他创伤性事件”(HR=1.9)、“曾实施或目睹暴力行为”(HR=1.7)和“曾被殴打或目睹家中发生肢体冲突”(HR=1.5)。对于自杀企图,报告“曾被配偶、伴侣、他人殴打、遭持械抢劫或被跟踪”(HR=3.8)和“曾遭受其他创伤性事件”(HR=2.0)的个体具有更高的风险。与无创伤性事件的个体相比,报告发生更多类型创伤性事件的个体出现自杀意念和自杀企图的风险增加。
我们的样本代表了墨西哥最大都市区,但不包括其他城市或年龄组,这些地区的危险因素可能不同。未考虑两次调查之间 8 年内发生的创伤性事件。创伤性事件增加了自杀行为的风险,与常见精神障碍无关。因此,在临床环境中识别和处理这些事件可能对预防该人群的自杀行为很重要。