Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations
Trends in suicidal behaviour and use of mental health services in Canadian military and civilian populations
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DOI：
10.1503/cmaj.151047
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发表时间：
2016-08-09
影响因子：
14.6
通讯作者：
Zamorski, Mark A.
中科院分区：
文献类型：
--
作者：
Sareen, Jitender;Afifi, Tracie O.;Zamorski, Mark A.
背景资料：就加拿大在阿富汗的使命而言，媒体大量关注加拿大部队人员的心理健康和缺乏治疗机会的问题。我们比较了2002年至2012/13年加拿大军人和普通人群之间自杀行为和精神卫生服务使用的流行趋势。方法：我们获得了18-60岁的受访者的数据，他们参加了加拿大统计局的4项全国代表性调查，旨在比较人口和趋势。2002年（n = 25 643）和2012年（n = 15 981）对普通人群进行了调查; 2002年（n = 5 153）和2013年（n = 6 700）对军事人员进行了调查。我们评估了自杀意念、计划和企图以及精神卫生服务的使用情况。结果：在2012/13年，军事人员的自杀意念和自杀意念的发生率显著高于平民，但在2002年没有（终生：校正比值比[OR] 1.32，95%置信区间[CI] 1.17-1.50;过去一年：校正OR 1.34，95% CI 1.09-1.66）。自杀计划也是如此（终生：调整后OR 1.64，95% CI 1.35-1.99;过去一年：调整后OR 1.66，95% CI 1.18-2.33）。2002年和2003年，在报告过去一年有自杀意念的受访者中，军队中的受访者过去一年对精神卫生服务的利用率明显高于平民（调整后OR 2.02，95% CI 1.31-3.13）和2012/13（调整后OR 3.14，95% CI 1.86-5.28）。解释：加拿大部队人员在2012/13年度自杀意念和计划的流行率较高，在2002年和2012/13年度使用心理健康服务的比例高于平民。
Background: In the context of the Canadian mission in Afghanistan, substantial media attention has been placed on mental health and lack of access to treatment among Canadian Forces personnel. We compared trends in the prevalence of suicidal behaviour and the use of mental health services between Canadian military personnel and the general population from 2002 to 2012/13.Methods: We obtained data for respondents aged 18-60 years who participated in 4 nationally representative surveys by Statistics Canada designed to permit comparisons between populations and trends over time. Surveys of the general population were conducted in 2002 (n = 25 643) and 2012 (n = 15 981); those of military personnel were conducted in 2002 (n = 5153) and 2013 (n = 6700). We assessed the lifetime and past-year prevalence of suicidal ideation, plans and attempts, as well as use of mental health services.Results: In 2012/13, but not in 2002, military personnel had significantly higher odds of both lifetime and past-year suicidal ideation than the civilian population (lifetime: adjusted odds ratio [OR] 1.32, 95% confidence interval [CI] 1.17-1.50; past year: adjusted OR 1.34, 95% CI 1.09-1.66). The same was true for suicidal plans (lifetime: adjusted OR 1.64, 95% CI 1.35-1.99; past year: adjusted OR 1.66, 95% CI 1.18-2.33). Among respondents who reported past-year suicidal ideation, those in the military had a significantly higher past-year utilization rate of mental health services than those in the civilian population in both 2002 (adjusted OR 2.02, 95% CI 1.31-3.13) and 2012/13 (adjusted OR 3.14, 95% CI 1.86-5.28).Interpretation: Canadian Forces personnel had a higher prevalence of suicidal ideation and plans in 2012/13 and a higher use of mental health services in 2002 and 2012/13 than the civilian population.