Cui Ying, Wu Tong, Du Huimin, Zhang Wen
Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea.
Department of Otolaryngology, Xinjiang Medical University Affiliated First Hospital, Urumqi, China.
Gen Hosp Psychiatry. 2025 Jan-Feb;92:52-59. doi: 10.1016/j.genhosppsych.2024.12.014. Epub 2024 Dec 22.
Suicidal ideation is a critical public health concern, and its relationship with hearing status has garnered increasing attention. This study aimed to investigate the association between hearing status and suicidal ideation in a nationally representative sample of U.S. adults.
Data were analyzed from 8095 participants in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression models, along with restricted cubic spline (RCS) analyses, explored the relationship between hearing status and suicidal ideation, adjusting for potential confounders. Subgroup analyses by sex, race, education level, marital status, family monthly poverty level, vision trouble, mobility trouble, smoking, hypertension, diabetes, coronary heart disease, stroke, and cancer were conducted. A Zero-Inflated Poisson (ZIP) regression model was applied to explore the association between hearing status and the level of suicidal ideation.
Participants with more difficulty hearing showed a higher likelihood of experiencing suicidal ideation (P < 0.05 for all). Further analysis using RCS regression confirmed a linear relationship between hearing status and suicidal ideation risk (P > 0.05). Subgroup analyses revealed no significant interactions across different stratifications (P > 0.05 for all). The ZIP analysis revealed that individuals with moderate hearing trouble or those identified as deaf or hard of hearing exhibited higher frequencies of suicidal ideation.
This study identifies an association between hearing status and suicidal ideation among U.S. adults. Factors such as discrimination, social isolation, environmental inaccessibility, and communication barriers may underlie this relationship. Interventions aimed at reducing suicidal ideation should focus on addressing these underlying factors, improving access to supportive resources, and promoting inclusive and accommodating environments for individuals with hearing difficulties.
自杀意念是一个关键的公共卫生问题，其与听力状况的关系已受到越来越多的关注。本研究旨在调查美国成年人全国代表性样本中听力状况与自杀意念之间的关联。
对2015 - 2018年国家健康与营养检查调查（NHANES）的8095名参与者的数据进行分析。加权逻辑回归模型以及受限立方样条（RCS）分析探讨了听力状况与自杀意念之间的关系，并对潜在混杂因素进行了调整。按性别、种族、教育水平、婚姻状况、家庭月贫困水平、视力问题、行动不便、吸烟、高血压、糖尿病、冠心病、中风和癌症进行了亚组分析。应用零膨胀泊松（ZIP）回归模型探讨听力状况与自杀意念水平之间的关联。
听力困难较大的参与者出现自杀意念的可能性更高（所有P < 0.05）。使用RCS回归的进一步分析证实了听力状况与自杀意念风险之间存在线性关系（P > 0.05）。亚组分析显示不同分层之间无显著交互作用（所有P > 0.05）。ZIP分析显示，中度听力困难的个体或被确定为失聪或听力障碍的个体自杀意念出现频率更高。
本研究确定了美国成年人中听力状况与自杀意念之间的关联。歧视、社会隔离、环境不便和沟通障碍等因素可能是这种关系的潜在原因。旨在减少自杀意念的干预措施应侧重于解决这些潜在因素，改善获得支持资源的机会，并为听力困难者营造包容和便利的环境。
