Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland.
Eur Psychiatry. 2023 Feb 27;66(1):e29. doi: 10.1192/j.eurpsy.2023.14.
Accumulating evidence indicates that a variety of distal and proximal factors might impact a risk of suicide. However, the association between both groups of factors remains unknown. Therefore, in the present study, we aimed to investigate the interplay between distal and proximal correlates of the current suicidal ideation.
A total of 3,000 individuals (aged 18-35 years, 41.7% males), who had reported a negative history of psychiatric treatment, were enrolled through an online computer-assisted web interview. Self-reports were administered to measure: (a) distal factors: a history of childhood trauma (CT), reading disabilities (RDs), symptoms of attention-deficit/hyperactivity disorder (ADHD), lifetime history of non-suicidal self-injury (NSSI), lifetime problematic substance use as well as family history of schizophrenia and mood disorders; (b) proximal factors: depressive symptoms, psychotic-like experiences (PLEs), and insomnia; and (c) sociodemographic characteristics.
Suicidal ideation was directly associated with unemployment, being single, higher level of RD, lifetime history of NSSI as well as higher severity of PLEs, depression, and insomnia. The association of distal factors with suicidal ideation was fully (a history of CT and symptoms of ADHD) or partially (a history of NSSI and RD) mediated by proximal factors (PLEs, depression, and insomnia).
Main findings from this study posit the role of distal factors related to neurodevelopmental disorders, CT and NSSI in shaping suicide risk. Their effects might be partially or fully mediated by depression, PLEs, and insomnia.
越来越多的证据表明,各种远端和近端因素可能会影响自杀风险。然而,这两组因素之间的关系尚不清楚。因此,在本研究中,我们旨在探讨当前自杀意念的远端和近端相关因素之间的相互作用。
共有 3000 名(年龄 18-35 岁,41.7%为男性)报告有精神科治疗史的个体通过在线计算机辅助网络访谈进行了入组。自我报告用于评估:(a)远端因素:儿童期创伤史(CT)、阅读障碍(RDs)、注意力缺陷/多动障碍(ADHD)症状、非自杀性自伤(NSSI)的终生史、终生有问题的物质使用以及精神分裂症和心境障碍家族史;(b)近端因素:抑郁症状、类精神病体验(PLEs)和失眠;和(c)社会人口学特征。
自杀意念与失业、单身、RD 程度较高、NSSI 的终生史以及 PLEs、抑郁和失眠的严重程度较高直接相关。远端因素与自杀意念的关联完全(CT 史和 ADHD 症状)或部分(NSSI 史和 RD)由近端因素(PLEs、抑郁和失眠)介导。
本研究的主要发现表明与神经发育障碍、CT 和 NSSI 相关的远端因素在塑造自杀风险方面发挥作用。它们的影响可能部分或完全由抑郁、PLEs 和失眠介导。