Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.
Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.
J Psychiatr Res. 2022 Sep;153:213-222. doi: 10.1016/j.jpsychires.2022.07.014. Epub 2022 Jul 9.
While research on suicidal behavior for people with disability (PWD) suggests they experience higher risk than people without disability, less is known about variations among individuals with different disability types. This nationally representative, cross-sectional study compared differences in suicide-related outcomes (ideation, planning, attempts) among PWD by functional disability type (hearing, vision, cognitive, mobility, complex activity) and number. Secondary analysis of adult PWD in the 2015-2019 National Survey on Drug Use and Health (unweighted N = 35,544; representing 47,723,378 PWD, weighted) was used to estimate relationships between suicide-related outcomes and disability type and number. Most respondents were female (55.9%), and 36.0% were aged ≥65 years. Adjusted odds ratios (AORs) from multivariable logistic regression indicated that suicidal ideation and suicide attempt, respectively, were significantly more likely among individuals with cognitive (AOR = 1.71, 95% CI = 1.24-2.35; AOR = 2.54, 95% CI = 1.31-4.91), complex activity (AOR = 1.96, 95% CI = 1.37-2.81; AOR = 2.67, 95% CI = 1.32-5.41), and ≥2 limitations (AOR = 2.02, 95% CI = 1.52-2.69; AOR = 3.46, 95% CI = 1.84-6.50) than hearing limitation. Also, relative to other disability types, suicide-related outcomes were significantly more likely among individuals with cognitive limitation and complex activity limitation (p < 0.001). Additionally, suicide-related outcomes elevated in likelihood as the number of limitations increased, with the largest associations among those with ≥5 limitations for suicidal ideation (AOR = 2.31, 95% CI = 1.46-3.66), suicide planning (AOR = 3.34, 95% CI = 1.97-5.68), and suicide attempt (AOR = 6.37, 95% CI = 3.76-10.79). Subgroup analyses showed that presence of cognitive limitation and multiple limitations differentiated between suicidal ideators and suicide attempters. Further research is needed to identify causes of these risks and develop suicide prevention efforts for these particularly vulnerable groups.
虽然针对残疾人群（PWD）自杀行为的研究表明，他们的风险高于非残疾人群，但对于不同残疾类型人群之间的差异知之甚少。本项全国代表性横断面研究比较了不同功能残疾类型（听力、视力、认知、行动、复杂活动）和残疾数量的 PWD 之间与自杀相关的结局（意念、计划、尝试）的差异。使用 2015-2019 年全国毒品使用与健康调查（未加权 N=35544；代表 47723378 名 PWD，加权）中的成年 PWD 进行二次分析，以估计与自杀相关的结局与残疾类型和数量之间的关系。大多数受访者为女性（55.9%），36.0%年龄≥65 岁。多变量逻辑回归的调整后比值比（AOR）表明，与听力障碍相比，分别存在认知障碍（AOR=1.71，95%CI=1.24-2.35；AOR=2.54，95%CI=1.31-4.91）、复杂活动障碍（AOR=1.96，95%CI=1.37-2.81；AOR=2.67，95%CI=1.32-5.41）和≥2 项限制（AOR=2.02，95%CI=1.52-2.69；AOR=3.46，95%CI=1.84-6.50）的个体更有可能出现自杀意念和自杀企图。此外，与其他残疾类型相比，认知障碍和复杂活动障碍的个体更有可能出现自杀相关结局（p<0.001）。此外，随着残疾数量的增加，自杀相关结局的可能性也会增加，其中与≥5 项残疾相关的自杀意念（AOR=2.31，95%CI=1.46-3.66）、自杀计划（AOR=3.34，95%CI=1.97-5.68）和自杀企图（AOR=6.37，95%CI=3.76-10.79）的关联最大。亚组分析表明，认知障碍和多种障碍的存在将自杀意念者和自杀企图者区分开来。需要进一步研究以确定这些风险的原因，并为这些特别脆弱的群体制定自杀预防措施。
