Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico.
Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico.
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DOI：
10.2147/ijgm.s17156
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发表时间：
2011-03-11
影响因子：
2.3
通讯作者：
Peña M
中科院分区：
文献类型：
--
作者：
Vera M;Reyes-Rabanillo ML;Huertas S;Juarbe D;Pérez-Pedrogo C;Huertas A;Peña M
在波多黎各，人们对全科医生患者的自杀意念知之甚少。在这项研究中，我们检查了慢性疾病的全科医生患者的自杀意念，计划和企图的比率，严重程度和相关性。这对于采取适当的干预措施和管理方法以尽量减少和预防自杀非常重要。我们在全科诊所筛查了患有慢性身体疾病的患者。自杀意念评估与自杀模块的迷你国际神经精神访谈。采用患者健康问卷抑郁模块评估重度抑郁症。采用多元Logistic回归分析社会人口学因素、抑郁与自杀意念的关系。在承认自杀意念的亚组中，我们使用多项logistic回归分析同时估计抑郁和社会人口因素与自杀风险水平的多变量关联。在2068例接受筛查的患者中，15.4%承认最近有自杀意念。在这一组中，8.6%的人报告了被动思维，3.7%的人报告了没有计划的主动思维，3.1%的人报告了有计划或尝试的主动思维。多因素Logistic回归分析显示，中重度抑郁症和重度抑郁症患者的自杀意念高于轻度抑郁症患者。64岁或64岁以下的患者承认自杀意念的可能性是65岁或65岁以上患者的1.5倍以上。与大学学历的患者相比，受教育程度较低的患者有自杀意念的风险高出两倍。多项逻辑回归分析显示，严重抑郁症与自杀计划或企图的可能性较高。这项研究的结果表明，公共卫生战略的重点是系统地识别抑郁症严重程度增加的患者，并实施循证抑郁症治疗，这与减少和预防慢性健康状况的全科患者的自杀行为有关。
Little is known about suicidal ideation among general practice patients in Puerto Rico. In this study we examined the rates, severity, and correlates of suicidal ideation, plans, and attempts among general practice patients with chronic illnesses. This is important in targeting appropriate interventions and management approaches to minimize and prevent suicide. We screened patients with chronic physical conditions at general practices. Suicidal ideation was assessed with the suicidality module of the Mini International Neuropsychiatric Interview. Major depression was assessed with the Patient Health Questionnaire depression module. The relationship between sociodemographic factors, depression and suicidal ideation was examined with multiple logistic regression analysis. Among the subgroup that acknowledged suicidal ideation, we used multinomial logistic regression analysis to estimate simultaneously the multivariate associations of depression and sociodemographic factors with suicidality risk levels. Of the 2068 patients screened, 15.4% acknowledged recent suicidal ideation. Among this group, 8.6% reported passive ideation, 3.7% active ideation without a plan, and 3.1% active ideation with a plan or attempt. According to multivariate logistic regression, suicidal ideation was higher among patients with moderately severe depression and severe depression than for those with milder symptoms. Patients aged 64 years or younger were over one and a half times more likely to acknowledge suicidal ideation than those aged 65 years and older. Compared with patients having a college degree, those with lower education had a twofold higher risk of suicidal ideation. Multinomial logistic regression analysis indicated that severe depression was associated with a higher likelihood of having a suicide plan or attempt. The findings of this study suggest that public health strategies focusing on the systematic identification of patients with increased depression severity and the implementation of evidence-based depression treatments are relevant for minimizing and preventing suicidal behavior among general practice patients with chronic health conditions.