Suicide ideation, depression and HIV among pregnant women in rural South Africa
Suicide ideation, depression and HIV among pregnant women in rural South Africa
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南非农村孕妇的自杀意念、抑郁症和艾滋病毒
DOI：
10.4236/health.2013.53a086
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发表时间：
2013
期刊：
影响因子：
2.1
通讯作者：
A. Stein
中科院分区：
文献类型：
--
作者：
T. Rochat;R. Bland;M. Tomlinson;A. Stein
背景资料：
尽管公众的看法与此相反，怀孕并不能提供保护性的
对自杀意念的影响。在低收入和中等收入国家（LMIC），
同时存在的风险因素包括计划外怀孕、艾滋病毒检测、亲密接触
伴侣暴力和抑郁可能会增加孕妇的自杀风险。我们研究了南非农村参加常规产前保健的妇女的自杀意念。方法：连续
109名妊娠后半段的妇女参加了一项横断面研究，
在夸祖鲁-纳塔尔农村地区的一个大型初级卫生保健设施进行的研究，
艾滋病毒感染率高。使用混合方法，使用
抑郁症结构化临床访谈（SCID）
DSM-IV诊断;定性访谈数据收集妇女的自杀意念和计划的经验。在常规治疗后两周，
艾滋病毒检测是预防母婴传播筛查的一部分。
结果：HIV阳性（49/109）和HIV阴性（60/109）的妇女进行了评估。
抑郁症的发生率很高（51/109，46.7%），在艾滋病毒阳性和
消极的女人自杀意念发生率高（30/109，27.5%），自杀意念多为自我
与自杀计划密切相关。年龄、既往抑郁症史和当前
抑郁与自杀意念显著相关。接近相等
艾滋病毒抗体呈阳性和阴性的妇女有自杀倾向。自杀的方法是
经常发生暴力行为，大多数妇女提到与家庭和伙伴关系冲突有关
意外怀孕或新感染艾滋病毒的人
是他们自杀意念的诱因结论：孕妇自杀意念发生率
接受艾滋病毒检测的妇女比例很高。艾滋病毒检测呈阳性会造成相当大的痛苦，
在艾滋病毒阴性的妇女中，计划外怀孕和意外怀孕是自杀意念的重要风险因素。妊娠
使妇女更多地接触保健服务，
预防和干预的机会。
Background:
Despite public perception to the contrary, pregnancy does not offer a protective
effect for suicide ideation. In low and middle income countries (LMIC) multiple
concurrent risk factors including unplanned pregnancies, testing for HIV, intimate
partner violence and depression may increase suicide risk among pregnant women. We examine suicide ideation among women attending routine antenatal care in rural South Africa. Method: A consecutive
series of 109 women in the second half of pregnancy were enrolled in a cross-sectional
study at a large primary health care facility in a rural area of KwaZulu-Natal with
high HIV prevalence. Using a mixed-methods approach, women were assessed using the
Major Depression Section of the Structured Clinical Interview for Depression (SCID)
for DSM-IV diagnosis; qualitative interview data were collected on women’s experiences of suicide ideation and plans. Women were assessed two weeks after routine
HIV testing as part of Prevention of Mother-to-Child Transmission (PMTCT) screening.
Results: Both HIV-positive (49/109) and HIV-negative (60/109) women were assessed.
Depression was high (51/109, 46.7%) and equally common amongst HIV-positive and
negative women. Suicide ideation was high (30/109, 27.5%) with thoughts of self
harm closely linked to suicide plans. Age, previous history of depression and current
depression were significantly associated with suicide ideation. Close to equal
numbers of HIV-positive and negative women were suicidal. Suicide methods were
frequently violent and most women cited family and partnership conflict related
to an unplanned pregnancy or their newly HIV-positive
status as triggers to their suicide ideation. Conclusions: Rates of suicide ideation among pregnant
women testing for HIV are high. Testing HIV-positive causes considerable distress,
and among HIV-negative women unplanned and unwanted pregnancies are important risk factors for suicide ideation. Pregnancy
brings women into increased contact with the health services with important
opportunities for prevention and intervention.
影响因子：
9.8
作者：
Lancaster CA;Gold KJ;Flynn HA;Yoo H;Marcus SM;Davis MM
通讯作者：
Davis MM
影响因子：
3.8
作者：
Carrico, Adam W.;Johnson, Mallory O.;Chesney, Margaret A.
通讯作者：
Chesney, Margaret A.
影响因子：
--
作者：
Govender, R. D.;Schlebusch, L.
通讯作者：
Schlebusch, L.