Determinants of suicidal ideation and suicide attempts: parallel cross-sectional analyses examining geographical location

BMC Psychiatry

Research Article

Tonelle E Handley¹  Brian J Kelly²  Kerry J Inder³  Terry J Lewin⁴  Natasha Weaver⁵  Amy Johnston⁶  Tim Slade⁶  Clare Coleman⁷ 

[1] Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia;Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Newcastle, New South Wales (NSW), Australia;Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Newcastle, New South Wales (NSW), Australia;Hunter Medical Research Institute, Newcastle, NSW, Australia;Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia;Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Newcastle, New South Wales (NSW), Australia;Hunter New England Mental Health Service, Newcastle, NSW, Australia;Hunter Medical Research Institute, Newcastle, NSW, Australia;School of Medicine and Public Health, University of Newcastle, Callaghan, Newcastle, NSW, Australia;National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia;Sydney Centre for Aboriginal and Torres Strait Islander Statistics, Faculty of Health Sciences, University of Sydney, Sydney, Australia;

关键词: Rural mental health;    Suicidal ideation;    Suicide attempts;    Psychiatric disorder;    Remoteness;    Social determinants of health;   

DOI  :  10.1186/1471-244X-14-208

 received in 2014-02-14, accepted in 2014-07-10,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundSuicide death rates in Australia are higher in rural than urban communities however the contributors to this difference remain unclear. Geographical differences in suicidal ideation and attempts were explored using two datasets encompassing urban and rural community residents to examine associations between socioeconomic, demographic and mental health factors. Differing patterns of association between psychiatric disorder and suicidal ideation and attempts as geographical remoteness increased were investigated.MethodsParallel cross-sectional analyses were undertaken using data from the 2007 National Survey of Mental Health and Wellbeing (2007-NSMHWB, n = 8,463), under-representative of remote and very remote residents, and selected participants from the Australian Rural Mental Health Study (ARMHS, n = 634), over-representative of remote and very remote residents. Uniform measures of suicidal ideation and attempts and mental disorder using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-3.0) were used in both datasets. Geographic region was classified into major cities, inner regional and other. A series of logistic regressions were undertaken for the outcomes of 12-month and lifetime suicidal ideation and lifetime suicide attempts, adjusting for age, gender and psychological distress. A sub-analysis of the ARMHS sample was undertaken with additional variables not available in the 2007-NSMHWB dataset.ResultsRates and determinants of suicidal ideation and suicide attempts across geographical region were similar. Psychiatric disorder was the main determinant of 12-month and lifetime suicidal ideation and lifetime suicide attempts across all geographical regions. For lifetime suicidal ideation and attempts, marital status, employment status, perceived financial adversity and mental health service use were also important determinants. In the ARMHS sub-analysis, higher optimism and better perceived infrastructure and service accessibility tended to be associated with a lower likelihood of lifetime suicidal ideation, when age, gender, psychological distress, marital status and mental health service use were taken into account.ConclusionsRates and determinants of suicidal ideation and attempts did not differ according to geographical location. Psychiatric disorder, current distress, employment and financial adversity remain important factors associated with suicidal ideation and attempts across all regions in Australia. Regional characteristics that influence availability of services and lower personal optimism may also be associated with suicidal ideation in rural communities.

【 授权许可】

CC BY   
© Inder et al.; licensee BioMed Central Ltd. 2014