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Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders
South African Journal of Psychology ( IF 1.9 ) Pub Date : 2020-11-23 , DOI: 10.1177/0081246320973838
Jason Bantjes 1 , Elsie Breet 1 , Christine Lochner 2 , Janine Roos 3 , Ronald C Kessler 4 , Dan J Stein 5
Affiliation  

Campus-based suicide prevention is an important priority for universities. One approach could be to identify and treat common mental disorders, but it is unclear what potential reduction in suicide might be achieved by such an approach. Our aim was to quantify this potential effect on prevalence of nonfatal suicidal behaviour among first-year students. Data were collected from students at two South African universities (N = 633) via an online survey. We assessed prevalence of nonfatal suicidal behaviour and six common mental disorders and used logistic regression models to identify all main and interaction associations of sociodemographic variables and common mental disorders as predictors of nonfatal suicidal behaviour. Population attributable risk analysis was used to quantify the potential reduction in nonfatal suicidal behaviour achieved by effectively treating common mental disorders, based on the simplifying assumption that the logistic regression coefficients of the common mental disorders represented causal effects on nonfatal suicidal behaviour. Twelve-month prevalence of suicidal ideation, plan, and attempt were 40.9%, 22.3%, and 3.9%, respectively. Increased risk was associated with identifying as Black, female and reporting an atypical sexual orientation. Of the six common mental disorders, major depressive disorder and generalised anxiety disorder were associated with all dimensions of nonfatal suicidal behaviour, bipolar spectrum disorder with increased risk of ideation and plan, attention-deficit/hyperactivity disorder with ideation, and alcohol use disorder with suicide plan. Population attributable risk analysis suggests that treating common mental disorders could yield absolute reductions in suicide ideation, plan, and attempt of 17.0%, 55.0% and 73.8%, respectively. Pragmatic trials are needed to evaluate the effects on nonfatal suicidal behaviour of identifying and treating students with a prior history of common mental disorder early in their university careers.



中文翻译:

减少大学生的非致命自杀行为:精算分析治疗常见精神障碍的潜在影响

基于校园的自杀预防是大学的重要优先事项。一种方法可能是识别和治疗常见的精神障碍,但目前尚不清楚通过这种方法可以实现何种潜在的自杀减少。我们的目的是量化这种对一年级学生非致命自杀行为发生率的潜在影响。数据是从两所南非大学(N = 633)。我们评估了非致命自杀行为和六种常见精神障碍的患病率,并使用逻辑回归模型确定了社会人口学变量和常见精神障碍的所有主要和相互作用关联,作为非致命自杀行为的预测指标。人口归因风险分析用于量化有效治疗常见精神障碍的非致命自杀行为的潜在减少,这是基于以下简化假设:常见精神障碍的逻辑回归系数代表对非致命自杀行为的因果关系。十二个月自杀意念,计划和尝试的患病率分别为40.9%,22.3%和3.9%。风险增加与识别为黑人有关,女性并报告非典型的性取向。在这六种常见的精神障碍中,重度抑郁障碍和广泛性焦虑障碍与非致命自杀行为,双相谱障碍(具有构想和计划的风险增加),注意力缺乏/多动症(具有构想)以及自杀性饮酒障碍有关。计划。人群归因风险分析表明,治疗常见的精神障碍可以使自杀观念,计划和尝试的自杀率绝对降低分别为17.0%,55.0%和73.8%。需要进行务实试验,以评估在大学职业生涯的早期就识别和治疗具有常见精神障碍病史的学生对非致命自杀行为的影响。重度抑郁症和广泛性焦虑症与非致命自杀行为,双相谱障碍和意念和计划风险增加,注意缺陷/多动症伴有想法,饮酒与自杀计划有关。人群归因风险分析表明,治疗常见的精神障碍可以使自杀观念,计划和尝试的自杀率绝对降低分别为17.0%,55.0%和73.8%。需要进行务实试验,以评估在大学职业生涯的早期就识别和治疗具有常见精神障碍病史的学生对非致命自杀行为的影响。重度抑郁症和广泛性焦虑症与非致命自杀行为,双相谱障碍和意念和计划风险增加,注意缺陷/多动症伴有想法,饮酒与自杀计划有关。人群归因风险分析表明,治疗常见的精神障碍可以使自杀观念,计划和尝试的自杀率绝对降低分别为17.0%,55.0%和73.8%。需要进行务实试验,以评估在大学职业生涯的早期就识别和治疗具有常见精神障碍病史的学生对非致命自杀行为的影响。注意缺陷/多动障碍伴有想法,饮酒障碍伴有自杀计划。人群归因风险分析表明,治疗常见的精神障碍可以使自杀观念,计划和尝试的自杀率绝对降低分别为17.0%,55.0%和73.8%。需要进行务实试验,以评估在大学职业生涯的早期就识别和治疗具有常见精神障碍病史的学生对非致命自杀行为的影响。注意缺陷/多动障碍伴有想法,饮酒障碍伴有自杀计划。人群归因风险分析表明,治疗常见的精神障碍可以使自杀观念,计划和尝试的自杀率绝对降低分别为17.0%,55.0%和73.8%。需要进行务实试验,以评估在大学职业生涯的早期就识别和治疗具有常见精神障碍病史的学生对非致命自杀行为的影响。

更新日期:2020-12-23
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