Psychiatric, Sociodemographic, and Community Belonging Correlates of Suicidal Ideation in Canada: Findings from the 2022 Mental Health and Access to Care Survey

초록

Objective To estimate the prevalence of suicidal ideation among Canadians, identify psychiatric and sociodemographic correlates of past-12-month ideation and its association with community belonging, and compare the out-of-fold predictive performance of logistic regression and random forest models.Method We analyzed the nationally representative 2022 Mental Health and Access to Care Survey (analytic n = 8,080; weighted population = 25,828,546). Survey-weighted logistic and multinomial regression used the master weight with 1,000 Fay-adjusted bootstrap replicate weights. Five-fold nested cross-validation compared a sociodemographic-plus-psychiatric logistic model, the same model with belonging added, and a random forest, using out-of-fold discrimination, average precision, Brier scores, and grouped permutation importance.Results Past-12-month suicidal ideation was reported by 3.4% (95% CI, 2.9% to 3.9%) and lifetime-only ideation by 7.4% (95% confidence interval (CI), 6.7% to 8.2%). Independent correlates of past-12-month ideation were major depressive episode (MDE) (adjusted odds ratio (aOR) = 5.80; 95% CI, 3.61 to 9.33), very weak community belonging (aOR = 3.64; 95% CI, 1.88 to 7.04), generalized anxiety disorder (aOR = 2.65; 95% CI, 1.56 to 4.50), bipolar disorder (aOR = 2.43; 95% CI, 1.27 to 4.66), and separation/divorce (aOR = 2.25; 95% CI, 1.22 to 4.17). Adjusted probability rose from 2.0% at very strong to 6.0% at very weak belonging. No interaction was supported. Adding belonging did not improve discrimination (area under the curve (AUC), 0.823 vs. 0.823; difference = 0.000; 95% CI, -0.011 to 0.011); the random forest AUC was 0.843 (difference = 0.020; 95% CI, 0.004 to 0.038).Conclusions Psychiatric morbidity, separation/divorce, younger age, and very weak community belonging were associated with past-12-month suicidal ideation. Community belonging was independently associated but did not improve cross-validated discrimination, whereas MDE was the most robust correlate. Objectif Estimer la pr & eacute;valence des id & eacute;es suicidaires chez les Canadiens, d & eacute;terminer les corr & eacute;lations psychiatriques et sociod & eacute;mographiques des id & eacute;es suicidaires au cours des 12 derniers mois et leur lien avec le sentiment d'appartenance & agrave; la communaut & eacute;, et comparer le rendement pr & eacute;dictif hors pli de la r & eacute;gression logistique et des mod & egrave;les de for & ecirc;t al & eacute;atoire.M & eacute;thode Nous avons analys & eacute; l'enqu & ecirc;te de 2022 sur la sant & eacute; mentale et l'acc & egrave;s aux soins, repr & eacute;sentative du pays (n analys & eacute; = 8 080; population pond & eacute;r & eacute;e = 25 828 546). La r & eacute;gression logistique et multinomiale pond & eacute;r & eacute;e par l'enqu & ecirc;te a utilis & eacute; la pond & eacute;ration principale avec 1 000 & eacute;chantillons r & eacute;p & eacute;t & eacute;s selon la m & eacute;thode d'auto-amor & ccedil;age ajust & eacute;e selon la m & eacute;thode de Fay. La validation crois & eacute;e imbriqu & eacute;e & agrave; cinq plis a compar & eacute; un mod & egrave;le logistique sociod & eacute;mographique et psychiatrique, le m & ecirc;me mod & egrave;le avec l'ajout d'une appartenance, et une for & ecirc;t al & eacute;atoire, en utilisant la discrimination hors pli, la pr & eacute;cision moyenne, les crit & egrave;res de Brier et l'importance par permutation group & eacute;e.R & eacute;sultats Les id & eacute;es suicidaires au cours des 12 derniers mois ont & eacute;t & eacute; signal & eacute;es dans 3,4% des cas (IC & agrave; 95% : 2,9% & agrave; 3,9%) et les id & eacute;es suicidaires au cours de la vie seulement dans 7,4% des cas (IC & agrave; 95% : 6,7% & agrave; 8,2%). Les corr & eacute;lats ind & eacute;pendants des id & eacute;es suicidaires au cours des 12 derniers mois & eacute;taient les suivants : EDM (rapport de cotes ajust & eacute; [RCa] = 5,80; IC & agrave; 95% : 3,61 & agrave; 9,33), sentiment tr & egrave;s faible d'appartenance & agrave; la communaut & eacute; (RCa = 3,64; IC & agrave; 95% : 1,88 & agrave; 7,04), trouble anxieux g & eacute;n & eacute;ralis & eacute; (RCa = 2,65; IC & agrave; 95% : 1,56 & agrave; 4,50), trouble bipolaire (RCa = 2,43; IC & agrave; 95% : 1,27 & agrave; 4,66) et s & eacute;paration/divorce (RCa = 2,25; IC & agrave; 95% : 1,22 & agrave; 4,17). La probabilit & eacute; ajust & eacute;e est pass & eacute;e de 2,0% avec un sentiment tr & egrave;s fort d'appartenance & agrave; 6,0% avec un sentiment tr & egrave;s faible d'appartenance. Aucune interaction n'a & eacute;t & eacute; approuv & eacute;e. L'ajout du sentiment d'appartenance n'a pas am & eacute;lior & eacute; la discrimination (aire sous la courbe [ASC]de 0,823 p/r & agrave; 0,823; diff & eacute;rence = 0,000; IC & agrave; 95% : -0,011 & agrave; 0,011); l'ASC de la for & ecirc;t al & eacute;atoire & eacute;tait de 0,843 (diff & eacute;rence = 0,020; IC & agrave; 95% : 0,004 & agrave; 0,038).Conclusions La morbidit & eacute; psychiatrique, la s & eacute;paration/le divorce, le jeune & acirc;ge et un tr & egrave;s faible sentiment d'appartenance & agrave; la communaut & eacute; ont & eacute;t & eacute; associ & eacute;s & agrave; des id & eacute;es suicidaires au cours des 12 derniers mois. Le sentiment d'appartenance & agrave; la communaut & eacute; & eacut

키워드