Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use
Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use
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DOI：
10.1176/appi.ajgp.10.4.417
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发表时间：
2002-07-01
影响因子：
7.2
通讯作者：
Sanchez, H
中科院分区：
文献类型：
--
作者：
Bartels, SJ;Coakley, E;Sanchez, H
作者确定了老年原发性脑血管病患者、抑郁症患者、焦虑症患者和高危饮酒患者的主动自杀意念和被动死亡意念的相关性。参与者包括2，240名老年初级保健患者（65岁以上），他们根据对Paykel自杀问题的回答被分为三个相互排斥的组：无意念，死亡意念和自杀意念。卡方检验、方差分析和多分类逻辑回归分析被用来确定与自杀意念相关的特征。自杀意念的最高数量与同时发生的重度抑郁症和焦虑症有关（18%），最低比例发生在高危饮酒中（3%）。亚洲人有自杀或死亡意念的比例最高（57%），非洲裔美国人最低（27%）。较少的社会支持和更严重的症状与更大的整体构思。死亡意念与最大的医疗并发症和最高的服务利用率相关。与之前的报告相反，作者没有发现主动自杀意念与与医疗保健提供者的接触增加有关。因此，对抑郁焦虑共病、社会隔离、低龄化、亚裔或高加索人种的老年门诊患者，应加强针对性的评估和预防服务。
The authors identified correlates of active suicidal ideation and passive death ideation in older primary cart, patients with depression, anxiety and at-risk alcohol use. Participants included 2,240 older primary care patients (age 65+), who were identified in three mutually exclusive groups on the basis of responses to the Paykel suicide questions: No Ideation, Death Ideation, and Suicidal Ideation. Chi-square, ANOVA, and polytomous logistic regression analyses were used to identify characteristics associated with suicidal ideation. The highest amount of suicidal ideation was associated with co-occurring major depression and anxiety disorder (18%), and the lowest proportion occurred in at-risk alcohol use (3%). Asians have the highest (57%) and African Americans have the lowest (27%) proportion of suicidal or death ideation. Fewer social supports and more severe symptoms were associated with greater overall ideation. Death ideation was associated with the greatest medical comorbidity and highest service utilization. Contrary to previous report,,;, authors failed to find that active suicidal ideation was associated with increased contact,,; with healthcare providers. Accordingly, targeted assessment and preventive services should be emphasized for geriatric outpatients with co-occurring depression and anxiety social isolation, younger age, and Asian or Caucasian race.