Department of Psychiatry, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong.
Department of Psychology, University of Cambridge, United Kingdom.
Eur Neuropsychopharmacol. 2023 Dec;77:4-11. doi: 10.1016/j.euroneuro.2023.08.485. Epub 2023 Sep 1.
People with mental disorders have increased risk of psychological distress during COVID-19. However, there is limited research comprehensively examining factors associated with suicidal ideation, the strongest predictor of suicidal behavior, among psychiatric patients amidst pandemic. We investigated prevalence and correlates of suicidal ideation in 407 Chinese psychiatric outpatients (diagnosed with mood, anxiety or schizophrenia-spectrum disorders) aged 18-64 years during the peak of fifth COVID-19 wave in Hong Kong between 28 March and 8 April, 2022, based on a comprehensive array of variables encompassing socio-demographics, illness profile, psychopathological symptoms, psychological measures and pandemic-related factors. Univariate and multivariate logistic regression analyses were conducted to determine correlates of suicidal ideation. Results showed that 128 (31.4%) participants exhibited suicidal ideation. Univariate analyses revealed that being unemployed or full-time student, more severe depressive, anxiety, PTSD-like, insomnia and psychotic symptoms, higher levels of loneliness, avoidant-coping, greater pandemic-related stress burden and distress by social-distancing measures were related to suicidal ideation. Conversely, participants with higher monthly household-income, better quality-of-life, and greater resilience were less likely to have suicidal ideation. Notably, only depressive symptom severity was retained in final multivariate model as a factor significantly associated with suicidal ideation. Hence, we observed that approximately one-third of Chinese psychiatric patients experienced suicidal ideation during fifth pandemic wave. Our findings underscore the influence of depressive symptoms being above and beyond that of other psychopathological symptoms, psychological and pandemic-related variables on suicidal ideation. Longitudinal research is required to clarify suicidal ideation trajectories and predictors of persistent suicidal ideation across pandemic and post-pandemic periods.
患有精神障碍的人在 COVID-19 期间心理困扰的风险增加。然而，在大流行期间，针对精神科患者中与自杀意念（自杀行为的最强预测指标）相关的因素，仅有有限的研究进行了全面检查。我们调查了 2022 年 3 月 28 日至 4 月 8 日香港第五波 COVID-19 高峰期期间，407 名年龄在 18-64 岁的中国精神科门诊患者（诊断为心境、焦虑或精神分裂症谱系障碍）的自杀意念发生率及其相关因素，这些患者接受了全面的变量评估，包括社会人口统计学、疾病特征、精神病理症状、心理测量和大流行相关因素。进行了单变量和多变量逻辑回归分析，以确定自杀意念的相关因素。结果显示，128 名（31.4%）参与者表现出自杀意念。单变量分析显示，失业或全日制学生、更严重的抑郁、焦虑、创伤后应激样、失眠和精神病症状、更高水平的孤独感、回避应对、更大的大流行相关压力负担和社交距离措施引起的困扰与自杀意念有关。相反，月家庭收入较高、生活质量较好和适应能力较强的参与者自杀意念较低。值得注意的是，只有抑郁症状严重程度在最终的多变量模型中保留为与自杀意念显著相关的因素。因此，我们观察到大约三分之一的中国精神科患者在第五波大流行期间经历了自杀意念。我们的研究结果强调了抑郁症状对自杀意念的影响，超过了其他精神病理症状、心理和大流行相关变量的影响。需要进行纵向研究，以阐明整个大流行和大流行后期间自杀意念的轨迹和持续自杀意念的预测因素。
