东非三个难民营中有代表性的社区家庭样本中自杀倾向的患病率及自杀风险相关因素
Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps.
作者信息
Scharpf Florian, Masath Faustine Bwire, Mkinga Getrude, Kyaruzi Edna, Nkuba Mabula, Machumu Maregesi, Hecker Tobias
机构信息
Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany.
Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2024 Feb;59(2):245-259. doi: 10.1007/s00127-023-02506-z. Epub 2023 Jun 5.
PURPOSE
To assess the prevalence of suicidality and associated factors of suicide risk in a sample of Burundian refugee families living in three refugee camps in Tanzania.
METHODS
Children (n = 230) and their parents (n = 460) were randomly selected and interviewed about suicidality (suicidal ideation, plans, and attempts) and a range of sociodemographic, psychological, and environmental factors. Multinomial logistic regression analyses were conducted to examine factors associated with children and parents' lower and moderate or high current suicide risk.
RESULTS
Past-month prevalence of suicidal ideation, plans, and attempts were 11.3%, 0.9% and 0.9%, respectively, among children; 37.4%, 7.4% and 5.2%, respectively, among mothers; and 29.6%, 4.8% and 1.7%, respectively, among fathers. Older age in years (aOR = 2.20, 95% CI 1.38-3.51; aOR = 3.03, 95% CI 1.15-7.99) and higher levels of posttraumatic stress disorder symptoms (aOR = 1.64, 95% CI 1.05-2.57; aOR = 2.30, 95% CI: 1.02-5.16), internalizing (aOR = 2.88, 95% CI 1.33-6.26) and externalizing problems (aOR = 1.56, 95% CI: 1.06-2.31; aOR = 3.03, 95% CI 1.42-6.49) were significantly positively associated with children's current suicide risk. For mothers, higher perceived instrumental social support (aOR = 0.05, 95% CI < 0.01-0.58) was significantly negatively related to suicide risk, whereas exposure to community violence (aOR = 1.97, 95% CI 1.30-2.99; aOR = 1.59, 95% CI 1.00-2.52), living in larger households (aOR = 1.74, 95% CI 1.17-2.57), and higher psychological distress (aOR = 1.67, 95% CI 1.05-2.67) were significantly positively associated with suicide risk. For fathers, higher perceived instrumental social support (aOR = 0.04, 95% CI < 0.01-0.44) and having more years of formal education (aOR = 0.58, 95% CI 0.34-0.98) were significantly negatively and exposure to war-related trauma (aOR = 1.81, 95% CI 1.03-3.19) was significantly positively associated with suicide risk.
CONCLUSION
Prevention programs should target psychopathology, community violence and social support to mitigate children and parents' current suicide risk.
目的
评估生活在坦桑尼亚三个难民营中的布隆迪难民家庭样本中的自杀倾向患病率及自杀风险相关因素。
方法
随机选取儿童（n = 230）及其父母（n = 460），就自杀倾向（自杀意念、计划和企图）以及一系列社会人口学、心理和环境因素进行访谈。进行多项逻辑回归分析，以检验与儿童和父母当前较低、中度或高度自杀风险相关的因素。
结果
在儿童中，过去一个月内自杀意念、计划和企图的患病率分别为11.3%、0.9%和0.9%；在母亲中分别为37.4%、7.4%和5.2%；在父亲中分别为29.6%、4.8%和1.7%。年龄较大（儿童：调整后比值比[aOR]=2.20，95%置信区间[CI]1.38 - 3.51；父亲：aOR = 3.03，95% CI 1.15 - 7.99）、创伤后应激障碍症状水平较高（儿童：aOR = 1.64，95% CI 1.05 - 2.57；父亲：aOR = 2.30，95% CI：1.02 - 5.16）、内化问题（儿童：aOR = 2.88，95% CI 1.33 - 6.26）和外化问题（儿童：aOR = 1.56，95% CI：1.06 - 2.31；父亲：aOR = 3.03，95% CI 1.42 - 6.49）与儿童当前的自杀风险显著正相关。对于母亲，较高的感知工具性社会支持（aOR = 0.05，95% CI < 0.0! - 0.58）与自杀风险显著负相关，而遭受社区暴力（aOR = 1.97，95% CI 1.30 - 2.99；aOR = 1.59，95% CI 1.00 - 2.52）、生活在大家庭中（aOR = 1.74，95% CI 1.17 - 2.57）以及较高的心理困扰（aOR = 1.67，95% CI 1.05 - 2.67）与自杀风险显著正相关。对于父亲，较高的感知工具性社会支持（aOR = 0.04，95% CI < 0.01 - 0.44）和受正规教育年限较多（aOR = 0.58，95% CI 0.34 - 0.98）与自杀风险显著负相关，而遭受与战争相关的创伤（aOR = 1.81，95% CI 1.03 - 3.19）与自杀风险显著正相关。
结论
预防项目应针对精神病理学、社区暴力和社会支持，以降低儿童和父母当前的自杀风险。
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