농촌지역 주민들에서 만성 의학적 질환이 자살사고에 미치는 영향 : 성인과 노인의 차이

Abstract

Objectives：This study attempted to investigate the effects of chronic medical diseases on suicidal ideation in a rural population, focusing on differences between adults and elderly individuals. Methods：We conducted a community-based, cross-sectional study on 682 subjects residing in rural areas. Participants aged 18–79 years were interviewed at home to assess the presence of current or past chronic medical diseases(lifetime). All participants completed the Center for Epidemiologic Studies Depression scale, Beck Scale for Suicide Ideation, Beck Anxiety Inventory, Alcohol Use Disorder Identification Test, and Barratt Impulsiveness Scale-11. Multiple logistic regression analysis was conducted to analyze the influences of chronic medical diseases on suicidal ideation in the “adult group” and “elderly group.” Results：In the unadjusted model, cardiovascular diseases(odds ratio : OR, 11.86; 95% confidence interval : 95% CI, 3.07-45.83), arthritis(OR, 3.72; 95% CI, 1.55-8.95), and cerebrovascular diseases(OR, 9.47 : 95% CI, 2.6434.00) were significantly associated with increased suicidal ideation among adults. Furthermore, the association between cardiovascular diseases and increased suicidal ideation remained significant(OR, 12.53 : 95% CI, 1.51104.17) after adjusting for sociodemographic factors, depression, anxiety, impulsivity, and problematic alcohol use. In elderly group, arthritis was the only significant risk factor for increased suicidal ideation in both unadjusted and adjusted models(OR, 2.80; 95% CI, 1.13-6.94 and OR, 3.71; 95% CI, 1.05-13.08, respectively). Conclusion：Chronic medical diseases that were associated with suicidal ideation differed by age group. This study suggests that primary-care physicians need to carefully assess suicidal ideation in adult patients with cardiovascular diseases and elderly patients with arthritis.