非医学社会决定因素、综合征条件与寻求治疗的社区样本中的自杀想法和行为：潜在类别分析。
Nonmedical Social Determinants, Syndemic Conditions, and Suicidal Thoughts and Behaviors in a Treatment-seeking Community Sample: A Latent Class Analysis.
出版信息
Arch Suicide Res. 2023 Jul-Sep;27(3):1063-1082. doi: 10.1080/13811118.2022.2108741. Epub 2022 Aug 10.
OBJECTIVE
Knowledge gaps remain regarding whether syndemic conditions identify treatment-seeking individuals most at risk for suicidal thoughts and behaviors (STB). We employed latent class analysis to: (1) model treatment-seeking individuals' syndemic conditions, (2) examine latent classes across nonmedical social determinants, and (3) assess associations between class membership and STB.
METHOD
Participants were 982 individuals presenting at a community mental health clinic between October 2014 and February 2020. The three-step latent class analytic approach was used. Regression analyses were employed to examine nonmedical social determinants and STB outcomes associated with class membership.
RESULTS
Participants were aged 18 to >72 (75.8% White; 76.7% heterosexual; 53.7% cisgender woman; 73.8% earned ≥$20,000 annually). Latent class analysis resulted in a three-class solution. Participants in Class 1 were characterized by low probabilities across syndemic conditions. Class 2 was characterized by high probabilities of anxiety and depression. Class 3 was characterized by high probabilities of eating disorders, anxiety, and depression. Participants of color, sexual minority participants, cisgender women, and those experiencing financial distress were more likely to be in classes characterized by syndemic conditions. Classes characterized by syndemic conditions, relative to no syndemic conditions, were associated with greater risk of STB.
CONCLUSION
Findings confirm the concentrated clustering of co-occurring syndemic conditions among marginalized groups and highlight differing risks for those considering suicide or who have attempted suicide vs. those engaging in self-harm. Results underscore the need for resource allocation and multilevel interventions targeting syndemic conditions and suicidality for minority populations and those experiencing financial distress.
目的
关于是否存在综合征状况来确定寻求治疗的个体最有可能出现自杀意念和行为（STB），知识空白仍然存在。我们采用潜在类别分析：（1）对寻求治疗的个体的综合征状况进行建模，（2）检查非医疗社会决定因素的潜在类别，以及（3）评估类别成员与 STB 之间的关联。
方法
参与者为 982 名于 2014 年 10 月至 2020 年 2 月期间在社区心理健康诊所就诊的个体。采用三步潜在类别分析方法。回归分析用于检查与类别成员相关的非医疗社会决定因素和 STB 结果。
结果
参与者年龄为 18 岁至＞72 岁（75.8%为白人；76.7%为异性恋；53.7%为顺性别女性；73.8%每年收入≥$20,000）。潜在类别分析产生了一个三类别解决方案。第 1 类参与者的综合征状况出现的可能性较低。第 2 类的特点是焦虑和抑郁的可能性较高。第 3 类的特点是饮食失调、焦虑和抑郁的可能性较高。有色人种参与者、性少数群体参与者、顺性别女性以及经历财务困境的参与者更有可能处于以综合征状况为特征的类别中。与没有综合征状况相比，以综合征状况为特征的类别与 STB 的风险增加相关。
结论
研究结果证实了综合征状况在边缘化群体中的集中聚类，并强调了考虑自杀或有自杀企图的人与实施自我伤害的人之间存在不同的风险。研究结果强调了需要针对少数民族和经历财务困境的人群分配资源并实施针对综合征状况和自杀的多层次干预措施。
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