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Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
Nock, Matthew K.1; Hwang, Irving2; Sampson, Nancy2; Kessler, Ronald C.2; Angermeyer, Matthias3; Beautrais, Annette4; Borges, Guilherme5,6; Bromet, Evelyn7; Bruffaerts, Ronny8; de Girolamo, Giovanni9; de Graaf, Ron10; Florescu, Silvia11; Gureje, Oye12; Haro, Josep Maria13,14; Hu, Chiyi15,16; Huang, Yueqin17; Karam, Elie G.18,19; Kawakami, Norito20; Kovess, Viviane21; Levinson, Daphna22; Posada-Villa, Jose23; Sagar, Rajesh24; Tomov, Toma25; Viana, Maria Carmen26; Williams, David R.27
刊名PLOS MEDICINE
2009-08-01
DOI10.1371/journal.pmed.1000123
6期:8
收录类别SCI ; SSCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]COMORBIDITY SURVEY REPLICATION ; POSTTRAUMATIC-STRESS-DISORDER ; PSYCHIATRIC RISK-FACTORS ; DSM-IV DISORDERS ; MAJOR DEPRESSION ; PANIC DISORDER ; PSYCHOLOGICAL AUTOPSY ; RETROSPECTIVE REPORTS ; LIFETIME PREVALENCE ; ADOLESCENT SUICIDE
英文摘要

Background: Suicide is a leading cause of death worldwide. Mental disorders are among the strongest predictors of suicide; however, little is known about which disorders are uniquely predictive of suicidal behavior, the extent to which disorders predict suicide attempts beyond their association with suicidal thoughts, and whether these associations are similar across developed and developing countries. This study was designed to test each of these questions with a focus on nonfatal suicide attempts.

Methods and Findings: Data on the lifetime presence and age-of-onset of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) mental disorders and nonfatal suicidal behaviors were collected via structured face-to-face interviews with 108,664 respondents from 21 countries participating in the WHO World Mental Health Surveys. The results show that each lifetime disorder examined significantly predicts the subsequent first onset of suicide attempt (odds ratios [ORs] = 2.9-8.9). After controlling for comorbidity, these associations decreased substantially (ORs = 1.5-5.6) but remained significant in most cases. Overall, mental disorders were equally predictive in developed and developing countries, with a key difference being that the strongest predictors of suicide attempts in developed countries were mood disorders, whereas in developing countries impulse-control, substance use, and post-traumatic stress disorders were most predictive. Disaggregation of the associations between mental disorders and nonfatal suicide attempts showed that these associations are largely due to disorders predicting the onset of suicidal thoughts rather than predicting progression from thoughts to attempts. In the few instances where mental disorders predicted the transition from suicidal thoughts to attempts, the significant disorders are characterized by anxiety and poor impulse-control. The limitations of this study include the use of retrospective self-reports of lifetime occurrence and age-of-onset of mental disorders and suicidal behaviors, as well as the narrow focus on mental disorders as predictors of nonfatal suicidal behaviors, each of which must be addressed in future studies.

Conclusions: This study found that a wide range of mental disorders increased the odds of experiencing suicide ideation. However, after controlling for psychiatric comorbidity, only disorders characterized by anxiety and poor impulse-control predict which people with suicide ideation act on such thoughts. These findings provide a more fine-grained understanding of the associations between mental disorders and subsequent suicidal behavior than previously available and indicate that mental disorders predict suicidal behaviors similarly in both developed and developing countries. Future research is needed to delineate the mechanisms through which people come to think about suicide and subsequently progress from ideation to attempts.

语种英语
WOS记录号WOS:000269229800011
项目编号R01MH077883 ; R01MH070884 ; R13-MH066849 ; R01-MH069864 ; R01 DA016558 ; FIRCA R01-TW006481 ; QLG5-1999-01042 ; SANCO 2004123 ; FIS 00/0028 ; SAF 2000-158-CE
资助机构United States National Institute of Mental Health ; the Pfizer Foundation ; US Public Health Service ; Fogarty International Center ; the Pan American Health Organization ; Eli Lilly and Company ; Ortho-McNeil Pharmaceutical ; GlaxoSmithKline ; Ministry of Social Protection ; Saldarriaga Concha Foundation ; European Commission ; Piedmont Region (Italy) ; Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain ; Ministerio de Ciencia y Tecnologia, Spain ; Departament de Salut, Generalitat de Catalunya, Spain
引用统计
被引频次:264[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/50025
专题北京大学精神卫生研究所
作者单位1.Natl Sch Publ Hlth & Hlth Serv Management, Publ Hlth Res & Evidence Based Med Dept, Bucharest, Romania
2.Harvard Univ, Dept Psychol, Cambridge, MA 02138 USA
3.Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA
4.Ctr Publ Mental Hlth, Gosing Am Wagram, Austria
5.Univ Otago, Christchurch, New Zealand
6.Natl Inst Psychiat Mexico, Dept Epidemiol Res, Div Epidemiol & Psychosocial Res, Mexico City, DF, Mexico
7.Metropolitan Autonomous Univ, Mexico City, DF, Mexico
8.SUNY Stony Brook, Dept Psychiat, Stony Brook, NY 11794 USA
9.Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium
10.IRCCS, Ctr S Giovanni Dio Fatebenefratelli, Brescia, Italy
11.Netherlands Inst Mental Hlth & Addict, Utrecht, Netherlands
12.Univ Coll Ibadan Hosp, Ibadan, Nigeria
13.St Joan Deu SSM, Barcelona, Spain
14.ISCIII, Ciber Salud Mental CIBERSAM, Barcelona, Spain
15.Shenzhen Inst Mental Hlth, Shenzhen, Peoples R China
16.Shenzhen Kangning Hosp, Shenzhen, Peoples R China
17.Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China
18.Balamand Univ, Dept Psychiat & Clin Psychol, St George Hosp Univ Med Ctr, Fac Med, Beirut, Lebanon
19.MIND, IDRAAC, Beirut, Lebanon
20.Univ Tokyo, Dept Mental Hlth, Sch Publ Hlth, Tokyo, Japan
21.Univ Paris 05, EA 4069, MGEN Fdn Publ Hlth, Paris, France
22.Mental Hlth Serv Minist Hlth, Jerusalem, Israel
23.Pontificia Univ Javeriana, Ctr Med Sabana, Bogota, Colombia
24.All India Inst Med Sci, Dept Psychiat, New Delhi, India
25.New Bulgarian Univ, Inst Human Relat, Sofia, Bulgaria
26.Univ Sao Paulo, Sch Med, Inst Psychiat, Sect Psychiat Epidemiol, Sao Paulo, Brazil
27.Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, Boston, MA 02115 USA
推荐引用方式
GB/T 7714
Nock, Matthew K.,Hwang, Irving,Sampson, Nancy,et al. Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys[J]. PLOS MEDICINE,2009,6(8).
APA Nock, Matthew K..,Hwang, Irving.,Sampson, Nancy.,Kessler, Ronald C..,Angermeyer, Matthias.,...&Williams, David R..(2009).Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys.PLOS MEDICINE,6(8).
MLA Nock, Matthew K.,et al."Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys".PLOS MEDICINE 6.8(2009).
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