Attempted suicide in Sri Lanka - An epidemiological study of household and community factors.
Attempted suicide in Sri Lanka - An epidemiological study of household and community factors.
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DOI：
10.1016/j.jad.2018.01.028
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发表时间：
2018-05
影响因子：
6.6
通讯作者：
Metcalfe C
中科院分区：
文献类型：
--
作者：
Knipe DW;Gunnell D;Pearson M;Jayamanne S;Pieris R;Priyadarshana C;Weerasinghe M;Hawton K;Konradsen F;Eddleston M;Metcalfe C
一个人的自杀风险由个人特征决定，但也受到环境的影响。先前的研究表明，背景影响对自杀行为有一定作用，但缺乏来自亚洲的定量证据。收集了斯里兰卡农村 171 个社区 47,919 个家庭 165,233 人的个人和社区层面数据。收集了个人（年龄、性别、过去的自杀企图和个人社会经济地位（SEP））和家庭（家庭 SEP、农药使用、酒精使用和多代家庭）层面因素的数据。我们使用三级 Logit 模型来研究成分（个人）和情境（家庭/社区）影响。我们发现，家庭 21%（95% CI 18%、24%）和社区 4%（95% CI 3%、5%）之间的自杀未遂风险存在显着差异。通过低家庭 SEP（OR 2.37 95% CI 2.10, 2.67）、低社区 SEP（OR 1.45 95% CI 1.21, 1.74）和社区“问题”饮酒（OR 1.44 95% CI 1.19, 1.75）衡量的背景因素与自杀未遂风险增加相关。生活在酗酒家庭的妇女自杀未遂的风险较高。我们观察到多代家庭生活的保护作用（OR 0.53 95% CI 0.42，0.65）。结果是受访者报告的，涉及自杀未遂的终生报告，因此这项研究可能会受到社会期望反应的影响。我们的研究发现，在斯里兰卡，背景因素与个人企图自杀的风险相关，与个人的个人特征无关。一个人的环境会影响他们的自杀风险。亚洲缺乏调查背景因素的定量研究。斯里兰卡农村地区的自杀风险与社区和家庭 SEP 较低有关。社区“问题”饮酒会增加终生自杀未遂的风险。酗酒家庭中的女性自杀未遂的风险较高。
An individual's suicide risk is determined by personal characteristics, but is also influenced by their environment. Previous studies indicate a role of contextual effects on suicidal behaviour, but there is a dearth of quantitative evidence from Asia. Individual and community level data were collected on 165,233 people from 47,919 households in 171 communities in rural Sri Lanka. Data were collected on individual (age, sex, past suicide attempts and individual socioeconomic position (SEP)) and household (household SEP, pesticide access, alcohol use and multigenerational households) level factors. We used 3-level logit models to investigate compositional (individual) and contextual (household/community) effects. We found significant variation between households 21% (95% CI 18%, 24%) and communities 4% (95% CI 3%, 5%) in the risk of a suicide attempt. Contextual factors as measured by low household SEP (OR 2.37 95% CI 2.10, 2.67), low community SEP (OR 1.45 95% CI 1.21, 1.74), and community ‘problem’ alcohol use (OR 1.44 95% CI 1.19, 1.75) were associated with an increased risk of suicide attempt. Women living in households with alcohol misuse were at higher risk of attempted suicide. We observed a protective effect of living in multigenerational households (OR 0.53 95% CI 0.42, 0.65). The outcome was respondent-reported and refers to lifetime reports of attempted suicide, therefore this study might be affected by socially desirable responding. Our study finds that contextual factors are associated with an individual's risk of attempted suicide in Sri Lanka, independent of an individual's personal characteristics. A person's environment influences their suicide risk. There is a dearth of quantitative studies from Asia investigating contextual factors. Suicide risk in rural Sri Lanka is associated with low community and household SEP. Community ‘problem’ alcohol use increases the risk of lifetime suicide attempts. Women in households with alcohol misuse are at a higher risk of attempted suicide.
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影响因子：
2.9
作者：
Knipe DW;Gunnell D;Pieris R;Priyadarshana C;Weerasinghe M;Pearson M;Jayamanne S;Dawson AH;Mohamed F;Gawarammana I;Hawton K;Konradsen F;Eddleston M;Metcalfe C
通讯作者：
Metcalfe C
影响因子：
4.4
作者：
Evans, J;Middleton, N;Gunnell, D
通讯作者：
Gunnell, D
影响因子：
1.8
作者：
Agresti, A;Caffo, B;Ohman-Strickland, P
通讯作者：
Ohman-Strickland, P
影响因子：
1.8
作者：
Knipe DW;Pearson M;Borgstrøm R;Pieris R;Weerasinghe M;Priyadarshana C;Eddleston M;Gunnell D;Metcalfe C;Konradsen F
通讯作者：
Konradsen F
影响因子：
--
作者：
Dongre, Amol R;Deshmukh, Pradeep R
通讯作者：
Deshmukh, Pradeep R