The influence of the comorbidity between depression and alcohol use disorder on suicidal behaviors in the São Paulo Epidemiologic Catchment Area Study, Brazil
The influence of the comorbidity between depression and alcohol use disorder on suicidal behaviors in the São Paulo Epidemiologic Catchment Area Study, Brazil
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DOI：
10.1590/s1516-44462010005000027
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发表时间：
2010-12-01
影响因子：
5.5
通讯作者：
Wang, Yuan-Pang
中科院分区：
文献类型：
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作者：
Coêlho, Bruno Mendonça;Andrade, Laura Helena;Wang, Yuan-Pang
目的：在社区样本中调查自杀相关认知和行为（“死亡想法”、“死亡欲望”、“自杀想法”和“自杀企图”）与抑郁症（重度抑郁发作或心境恶劣）和酒精或物质使用障碍的共病之间的关系。方法：样本为 1464 名受试者，使用综合国际诊断访谈在家中进行访谈，以生成 DSM-III-R 诊断。描述性统计通过社会人口变量和考虑的诊断（重度抑郁发作、心境恶劣、酒精或物质使用障碍）描述了与自杀相关的认知和行为的流行程度。我们进行了多变量逻辑回归分析，以评估共病重度抑郁发作/心境恶劣以及酒精或物质使用障碍对每种自杀相关认知和行为的影响。结果：重度抑郁发作和心境恶劣与自杀相关的认知和行为显着相关。在回归模型中，即使存在酒精使用障碍（OR = 范围 2.3-4.0）或酒精或物质使用障碍（OR = 范围 2.7-2.8），重度抑郁发作（OR = 范围 2.3-9.2）和心境恶劣（OR = 范围 5.1-32.6）也可以预测与自杀相关的认知和行为。观察到重度抑郁发作和酒精使用障碍之间以及心境恶劣和性别之间的相互作用。大多数模型都排除了药物滥用障碍。结论：重度抑郁发作和心境恶劣会影响自杀相关的认知和行为，与酒精或物质使用障碍的存在无关。然而，酒精使用障碍和性别与抑郁症相互作用，对自杀相关的认知和行为表现出不同的影响。
Objective: To investigate in a community sample the association of suicide-related cognitions and behaviors ("thoughts of death", "desire for death", "suicidal thoughts", and "suicidal attempts") with the comorbidity of depressive disorders (major depressive episode or dysthymia) and alcohol or substance use disorders. Method: The sample was 1464 subjects interviewed in their homes using the Composite International Diagnostic Interview to generate DSM-III-R diagnosis. Descriptive statistics depicted the prevalence of suicide-related cognitions and behaviors by socio-demographic variables and diagnoses considered (major depressive episode, dysthymia, alcohol or substance use disorders). We performed a multivariate logistic regression analysis to estimate the effect of comorbid major depressive episode/dysthymia and alcohol or substance use disorders on each of the suicide-related cognitions and behaviors. Results: The presence of major depressive episode and dysthymia was significantly associated with suicide-related cognitions and behaviors. In the regression models, suicide-related cognitions and behaviors were predicted by major depressive episode (OR = range 2.3-9.2) and dysthymia (OR = range 5.1-32.6), even in the presence of alcohol use disorders (OR = range 2.3-4.0) or alcohol or substance use disorders (OR = range 2.7-2.8). The interaction effect was observed between major depressive episode and alcohol use disorders, as well as between dysthymia and gender. Substance use disorders were excluded from most of the models. Conclusion: Presence of major depressive episode and dysthymia influences suicide-related cognitions and behaviors, independently of the presence of alcohol or substance use disorders. However, alcohol use disorders and gender interact with depressive disorders, displaying a differential effect on suicide-related cognitions and behaviors.