Calegaro Gabriel, Soares Pedro San Martin, Colman Ian, Murray Joseph, Wehrmeister Fernando C, Menezes Ana M B, Gonçalves Helen
Postgraduate program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3(°) Piso, Pelotas 96020-220, Brazil..
Postgraduate program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3(°) Piso, Pelotas 96020-220, Brazil.
Child Abuse Negl. 2023 Oct 27;146:106517. doi: 10.1016/j.chiabu.2023.106517.
Suicide is the second most common cause of death among young individuals (10-25 years). The risk of first occurrence of suicidal behavior increases significantly at the start of adolescence, highlighting the importance of research regarding the association between early life factors, such as adverse childhood experiences (ACEs), and suicidal behaviors.
To assess if ACEs are prospectively associated with lifetime suicide attempt and suicidal thoughts at young adulthood.
Data from 3050 young adults from the 1993 Pelotas Birth Cohort.
Discrimination (of any type), financial hardship, maternal common mental disorders (CMD - SRQ-20), parental death, parental divorce and physical abuse were assessed at the 11-year follow-up. Data regarding suicidal thoughts and suicide attempt was assessed at 22 years with Mini International Neuropsychiatric Interview (MINI), version 5.0. Crude and adjusted logistic regression models were estimated.
In the adjusted model, those who suffered financial hardship (OR 2.51; 95 % CI 1.66-3.79), parental divorce (OR 1.44; 95 % CI 1.02-2.04) and maternal CMD (OR 1.72; 95 % CI 1.21-2.46) at 11 years were more likely to report suicidal thoughts at 22 years. Also, those who experienced financial hardship (OR 1.71; 95 % CI 1.13-2.58), physical abuse (OR 1.48; 95 % CI 1.08-2.04), discrimination (OR 1.74; 95 % CI 1.20-2.51), maternal CMD (OR 1.67; 95 % CI 1.20-2.32), or parental divorce (OR 1.41; 95 % CI 1.02-1.94) were more likely to report a lifetime suicide attempt.
There was a strong association between financial hardship, maternal CMD and divorce during childhood, and suicidal thoughts, such as suicidal ideation or planning, at the beginning of adulthood. Financial hardship, discrimination, divorce, maternal CMD and physical abuse were associated with suicide attempt. These findings demonstrate that mental health support must be available following certain ACEs during childhood, alongside with ACEs prevention. More research is needed on the association between discrimination and suicide attempts, differentiating the nature and impact of each type of discrimination.
自杀是10至25岁年轻人中第二大常见死因。自杀行为首次出现的风险在青春期开始时显著增加，这凸显了研究诸如童年不良经历（ACEs）等早期生活因素与自杀行为之间关联的重要性。
评估童年不良经历是否与成年早期的终生自杀未遂及自杀念头存在前瞻性关联。
来自1993年佩洛塔斯出生队列的3050名年轻人的数据。
在11年随访时评估歧视（任何类型）、经济困难、母亲常见精神障碍（CMD - SRQ - 20）、父母死亡、父母离异及身体虐待情况。在22岁时使用迷你国际神经精神病学访谈（MINI）5.0版评估自杀念头和自杀未遂的数据。估计了粗逻辑回归模型和调整逻辑回归模型。
在调整模型中，11岁时经历经济困难（比值比2.51；95%置信区间1.66 - 3.79）、父母离异（比值比1.44；95%置信区间1.02 - 2.04）和母亲患常见精神障碍（比值比1.72；95%置信区间1.21 - 2.46）的人在22岁时更有可能报告有自杀念头。此外，经历经济困难（比值比1.71；95%置信区间1.13 - 2.58）、身体虐待（比值比1.48；95%置信区间1.08 - 2.04）、歧视（比值比1.74；95%置信区间1.20 - 2.51）、母亲患常见精神障碍（比值比1.67；95%置信区间1.20 - 2.32）或父母离异（比值比1.41；95%置信区间1.02 - 1.94）的人更有可能报告有过终生自杀未遂经历。
童年时期的经济困难、母亲患常见精神障碍和父母离异与成年早期的自杀念头，如自杀意念或计划，之间存在密切关联。经济困难、歧视、离异、母亲患常见精神障碍和身体虐待与自杀未遂有关。这些发现表明，在童年经历某些不良童年经历后必须提供心理健康支持，同时也要预防不良童年经历。需要更多关于歧视与自杀未遂之间关联的研究，以区分每种歧视类型的性质和影响。
