Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA.
Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Psychiatry Res. 2024 Oct;340:116095. doi: 10.1016/j.psychres.2024.116095. Epub 2024 Jul 23.
Researchers predict long-term increases in suicide deaths following the COVID-19 pandemic. Little is known about risk factors for suicidal ideation (SI) and suicidal attempts (SA) or treatment barriers and promoters during the pandemic. We examine these factors in a young adult sample.
Analyses used a 2022 cross-sectional survey dataset (N = 1,956). Logistic regression identified factors associated with pandemic suicidality (i.e., SI, SA). Non-treatment seekers reported barriers to seeking treatment. Logistic regression identified promotive factors associated with treatment-seeking.
28.6 % of our sample developed suicidality during the pandemic, of whom 49.6 % did not seek treatment. Asian race and sexual minority status were strongly associated with increased odds of pandemic suicidality. Among SI non-treatment-seekers, barriers were primarily attitudinal (e.g., "symptoms are not serious enough for treatment"); among non-treatment-seekers with SA, barriers were mostly structural (e.g., insufficient funds). Previous depression treatment was strongly associated with increased odds of treatment-seeking.
Asian American individuals were at increased risk for pandemic suicidality, which may reflect interpersonal risks related to COVID-19-related anti-Asian racism. Our findings point to a "foot-in-the-door" effect: past treatment-seeking was positively associated with future treatment-seeking. To promote this effect and decrease barriers, we suggest integrated mental health screening and referrals in primary care.
研究人员预测，在 COVID-19 大流行之后，自杀死亡人数将长期增加。人们对大流行期间自杀意念（SI）和自杀企图（SA）的风险因素或治疗障碍和促进因素知之甚少。我们在年轻成人样本中研究了这些因素。
分析使用了 2022 年的横断面调查数据集（N=1956）。逻辑回归确定了与大流行自杀相关的因素（即 SI、SA）。未寻求治疗的非治疗寻求者报告了治疗障碍。逻辑回归确定了与寻求治疗相关的促进因素。
我们样本中有 28.6%的人在大流行期间出现了自杀倾向，其中 49.6%的人没有寻求治疗。亚洲种族和性少数群体地位与大流行自杀的几率增加密切相关。在 SI 非治疗寻求者中，障碍主要是态度方面的（例如，“症状严重程度不足以治疗”）；在没有 SA 寻求治疗的非治疗寻求者中，障碍主要是结构性的（例如，资金不足）。以前的抑郁治疗与寻求治疗的几率增加密切相关。
亚裔美国人患大流行自杀的风险增加，这可能反映了与 COVID-19 相关的反亚裔种族主义相关的人际风险。我们的研究结果表明存在“入门效应”：过去的治疗寻求与未来的治疗寻求呈正相关。为了促进这种效果并减少障碍，我们建议在初级保健中进行综合心理健康筛查和转介。
