Abstract
Background: Many studies have suggested that strategies of suicide prevention must be developed with a detailed understanding of the role of multiple risk factors. The aim of the current study was to explore the pathways of multiple risk factors for severe suicidal ideation (SSI) and provide empirical data and recommendations for suicide interventions.
Methods: A door-to-door survey was administered to 3,821 rural residents aged 15 and older in rural China. The risk factor variables were sociodemographic characteristics, depression, social support, quality of life and negative life events. Univariate and multivariate logistic regression models were used to analyze risk factors related to SSI, and structural equation modeling was used to analyze the pathways of risk factors for SSI.
Results: Depression, socio-economic status and negative life events had direct effects on SSI. Socio-economic status and negative life events had indirect effects on SSI via depression. The most influential factor of the direct effects was depression, and the most influential factor of the indirect effects was socio-economic status.
Conclusions: The direct and indirect effect pathways of risk factors contribute to the understanding of the role of multiple risk factors as well as the corresponding intervention strategies. The intervention in the acute phase perhaps should be mainly targeted on the direct factor of depression; before the acute phase (or even earlier) or after the acute phase, it should be mainly targeted on the indirect factor of socio-economic status.
Key words: Pathway analysis, suicidal ideation, crisis intervention, socio-economic status, depressionm p]Canada
Résumé
Contexte: Selon de nombreuses études, pour élaborer des stratégies de prévention du suicide, il faut avoir une connaissance approfondie du rôle des multiples facteurs de risque. Nous avons voulu explorer les pistes causales de multiples facteurs de risque liés aux idées suicidaires graves (ISG) et fournir des données empiriques et des recommandations d’interventions contre le suicide.
Méthode: Un sondage de porte en porte a été administré à 3 821 résidents de 15 ans et plus en Chine rurale. Les facteurs de risque variables étaient le profil sociodémographique, la dépression, le soutien social, la qualité de vie et les événements négatifs marquants. Au moyen de modèles de régression logistique univariés et multivariés, nous avons analysé les facteurs de risque liés aux ISG; une modélisation par équations structurelles a permis d’analyser les pistes causales des facteurs de risque liés aux ISG.
Résultats: La dépression, le statut socioéconomique et les événements négatifs marquants avaient des effets directs sur les ISG. Le statut socioéconomique et les événements négatifs marquants avaient des effets indirects sur les ISG via la dépression. Le facteur ayant le plus influencé les effets directs était la dépression, et le facteur ayant le plus influencé les effets indirects était le statut socioéconomique.
Conclusion: Les pistes causales des effets directs et indirects des facteurs de risque contribuent à la compréhension du rôle des multiples facteurs de risque ainsi que des stratégies d’intervention correspondantes. Les interventions en phase aigue devraient peut-être principalement cibler le facteur direct qu’est la dépression; avant la phase aigue (ou même plus tôt) ou après la phase aigue, elles devraient principalement cibler le facteur indirect qu’est le statut socioéconomique.
Mots clés: analyse des pistes causales, idées suicidaires, intervention de crise, statut socioéconomique, dépression
Footnotes
Conflict of Interest: None to declare.
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