Poor social integration and suicide: fact or artifact? A case-control study
Poor social integration and suicide: fact or artifact? A case-control study
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DOI：
10.1017/s0033291704002600
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发表时间：
2004-10-01
影响因子：
6.9
通讯作者：
Caine, ED
中科院分区：
文献类型：
--
作者：
Duberstein, PR;Conwell, Y;Caine, ED
背景社会学研究表明，社会融合不良会带来自杀风险。在对精神障碍和就业状况的影响进行统计学调整后，尚不清楚不良的整合是否会放大风险。采用病例对照设计，比较86例自杀者和86例50岁及以上的对照组，年龄、性别、种族和居住县匹配。结构化访谈进行了自杀和控制的代理受访者。社会融合的定义是指两个广泛的分析层次：家庭（如兄弟姐妹的地位，抚养子女的地位）和社会/社区（如社会互动，宗教参与，社区参与）。双变量分析显示，自杀者结婚、有孩子或与家人住在一起的可能性较小。他们不太可能参与宗教活动或社群活动，他们的社会交往水平较低。一个修剪的逻辑回归模型显示，婚姻状况，社会交往和宗教参与都与自杀有关，即使在情感障碍和就业状况的影响进行统计调整后。将药物滥用添加到模型中消除了宗教参与的影响。家庭和社会/社区的社会融合不良和自杀的指标之间的关联是强大的，在很大程度上独立于精神障碍的存在。研究结果可用于加强筛查工具，并确定问题行为，如低水平的社会互动，这可能是有针对性的干预。
Background. Sociological studies have shown that poor social integration confers suicide risk. It is not known whether poor integration amplifies risk after adjusting statistically for the effects of mental disorders and employment status.Method. A case-control design was used to compare 86 suicides and 86 living controls 50 years of age and older, matched on age, gender, race, and county of residence. Structured interviews were conducted with proxy respondents for suicides and controls. Social integration was defined in reference to two broad levels of analysis: family (e.g. sibship status, childrearing status) and social/community (e.g. social interaction, religious participation, community involvement).Results. Bivariate analyses showed that suicides were less likely to be married, have children, or live with family. They were less likely to engage in religious practice or community activities and they had lower levels of social interaction. A trimmed logistic regression model showed that marital status, social interaction and religious involvement were all associated with suicide even after statistical adjusting for the effects of affective disorder and employment status. Adding substance abuse to the model eliminated the effects of religious involvement.Conclusions. The association between family and social/community indicators of poor social integration and suicide is robust and largely independent of the presence of mental disorders. Findings could be used to enhance screening instruments and identify problem behaviors, such as low levels of social interaction, which could be targeted for intervention.