Exposure to Suicide in the Community: Prevalence and Correlates in One US State
Exposure to Suicide in the Community: Prevalence and Correlates in One US State
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DOI：
10.1177/003335491613100116
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发表时间：
2016-01-01
影响因子：
3.3
通讯作者：
Brown, Margaret
中科院分区：
文献类型：
--
作者：
Cerel, Julie;Maple, Myfanwy;Brown, Margaret
目标。自杀已被确定为一个主要的公共卫生问题。接触自杀（例如，知道有人死于自杀）比以前认为的要普遍得多，并且可能与严重的不良后果有关。随着公众对自杀的讨论越来越普遍，迫切需要确定哪些人有自杀风险，以及这种风险对身后的人有何影响。本研究估计了暴露于自杀的人口比例，并描述了在暴露后预测显著精神和社会心理疾病的因素。一项双帧随机数字拨号调查对肯塔基州1736名美国成年人进行了抽样调查。比较了自杀暴露者和未自杀暴露者的抑郁和焦虑。研究了精神状况和对死者亲近程度的感知之间的关系。48%的加权参与者（n=816/ 1687）报告一生中有自杀倾向。自杀暴露者当前的抑郁和焦虑症状高于未自杀暴露者。有自杀倾向的人被诊断为抑郁症的可能性是没有自杀倾向的人的两倍，被诊断为焦虑症的可能性几乎是没有自杀倾向的人的两倍。自杀暴露者比未自杀暴露者更有可能报告自杀意念（9%比5%）。与死者的亲密关系增加了抑郁和焦虑的几率，使患创伤后应激障碍的几率几乎增加了四倍。接触自杀是普遍的，发生在家庭之外；因此，识别那些被认为与死者关系密切的人是必要的。这一隐藏的自杀暴露人群出现精神病理和自杀意念的风险较高。
Objective. Suicide has been identified as a major public health issue. Exposure to suicide (i.e., knowing someone who died by suicide) is far more pervasive than previously considered and might be associated with significant adverse outcomes. As suicide becomes more commonly discussed in the public arena, a compelling need exists to determine who is exposed to suicide and how this exposure affects those left behind. This study estimated the proportion of the population exposed to suicide and delineated factors that predict significant psychiatric and psychosocial morbidity following that exposure.Methods. A dual-frame random-digit-dial survey was conducted on a sample of 1,736 U.S. adults in the Commonwealth of Kentucky. Depression and anxiety were compared in suicide-exposed and suicide-unexposed individuals. Relationships were examined between psychiatric outcomes and perceptions of closeness to the decedent.Results. Forty-eight percent of weighted participants (n=816/1,687) reported lifetime exposure to suicide. Current depression and anxiety symptoms were higher in suicide-exposed than in suicide-unexposed individuals. Suicide exposed individuals were twice as likely as suicide-unexposed individuals to have diagnosable depression and almost twice as likely to have diagnosable anxiety. Suicide-exposed individuals were more likely than suicide-unexposed individuals to report suicide ideation (9% vs. 5%). Closeness to the decedent increased the odds of depression and anxiety and almost quadrupled the odds of posttraumatic stress disorder.Conclusion. Exposure to suicide is pervasive and occurs beyond family; as such, it is imperative to identify those with perceived closeness to the decedent. This hidden cohort of suicide-exposed people is at elevated risk for psychopathology and suicidal ideation.