Busby Grant Janie, Batterham Philip J, McCallum Sonia M, Werner-Seidler Aliza, Calear Alison L
Faculty of Health, University of Canberra, Canberra, ACT, Australia.
Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia.
J Affect Disord. 2023 Apr 14;327:299-305. doi: 10.1016/j.jad.2023.02.024. Epub 2023 Feb 9.
Suicidality research has typically focused on affective disorders to identify at-risk youth. Investigating the predictive role of individual symptoms, particularly anxiety symptoms, may allow for preventative targeting of additional risk factors for suicidal ideation and attempts.
This analysis used the Sources of Strength Australia project dataset, a cluster randomised controlled trial which assessed the impact of a schools-based intervention for youth help-seeking over 18 months (Calear et al., 2022). Symptoms of anxiety, depression and distress at baseline were used to predict the onset of suicidal ideation, planning for suicide and suicide attempts at 18 months.
Worry, lack of sleep and anxiety interfering with everyday activities at baseline predicted new onset of suicidal ideation 18 months later. Worry about the future and past, reduced appetite and a belief that life wasn't worth living were risk factors for later suicide plans and attempts. Total scale scores on the scales were typically poor predictors of onset of suicidal behaviours.
Analyses were impacted by dropouts over the 18 month study period and restricted further investigation into potential behaviour transition trajectories.
These findings identify individual symptom profiles associated with later onset of suicidal behaviour. Broadening the focus beyond depression and hopelessness to incorporate anxiety, worry and reduced sleep as risk factors for suicidality is important for public health and clinical settings.
自杀倾向研究通常聚焦于情感障碍以识别有风险的青少年。调查个体症状的预测作用，尤其是焦虑症状，可能有助于针对自杀意念和自杀未遂的其他风险因素进行预防性干预。
本分析使用了澳大利亚力量之源项目数据集，这是一项整群随机对照试验，评估了一项为期18个月的针对青少年求助行为的学校干预措施的影响（卡利尔等人，2022年）。基线时的焦虑、抑郁和痛苦症状用于预测18个月时自杀意念、自杀计划和自杀未遂的发生情况。
基线时的担忧、睡眠不足以及干扰日常活动的焦虑症状可预测18个月后自杀意念的新发情况。对未来和过去的担忧、食欲减退以及认为生活不值得活下去是后来自杀计划和自杀未遂的风险因素。量表的总分通常不是自杀行为发生的良好预测指标。
分析受到18个月研究期间失访的影响，限制了对潜在行为转变轨迹的进一步调查。
这些发现确定了与后期自杀行为发生相关的个体症状特征。将关注点从抑郁和绝望扩展到纳入焦虑、担忧和睡眠减少作为自杀倾向的风险因素，对公共卫生和临床环境而言非常重要。
