Journal of affective disorders · 2018
Association of adult attachment and suicidal ideation in primary care patients with multiple chronic conditions.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Rückert-Eheberg Ina-Maria, Lukaschek Karoline, Brenk-Franz Katja, Strauß Bernhard, Gensichen Jochen
Аннотация
BACKGROUND: Suicidal ideation is a common health concern in primary care. Attachment theory indicates that subjects with higher anxiety and/or avoidance may be more susceptible to suicidal ideation. Therefore, the aim of our study was to examine the association of attachment anxiety, avoidance, and suicidal ideation in middle-aged to elderly, chronically ill primary care patients.
METHODS: The APRICARE Study comprised 207 patients aged 50-85 years with a minimum of three chronic diseases. Adult attachment, depressive symptoms and suicidal ideation were measured via the self-report questionnaires Experiences in Close Relationships-Revised (ECR-RD12) and Patient Health Questionnaire - 9 (PHQ-9). Univariable and adjusted associations of suicidal ideation with ECR-RD12-attachment anxiety, ECR-RD12-attachment avoidance, and ECR-RD12-insecure adult attachment were examined via logistic regression analyses.
RESULTS: Suicidal ideation was present in 13% of all patients. ECR-RD12-anxiety was significantly associated with suicidal ideation (OR = 1.88, CI 1.44-2.44), while ECR-RD12-avoidance was not associated. In patients with suicidal ideation, 85% were insecurely attached compared to 63% in those without suicidal ideation - thus the OR for suicidal ideation in insecurely attached patients was 3.33 (CI = 1.10-10.04) with securely attached patients as reference. Further variables associated with suicidal ideation were depressive symptomatology, living alone (especially in men) and obesity (especially in women).
LIMITATIONS: The study was cross-sectional in design, and suicidal ideation was assessed using a single item self-report measure.
CONCLUSION: General practitioners should be aware of attachment styles in order to have a better chance to identify patients at risk for suicide.
METHODS: The APRICARE Study comprised 207 patients aged 50-85 years with a minimum of three chronic diseases. Adult attachment, depressive symptoms and suicidal ideation were measured via the self-report questionnaires Experiences in Close Relationships-Revised (ECR-RD12) and Patient Health Questionnaire - 9 (PHQ-9). Univariable and adjusted associations of suicidal ideation with ECR-RD12-attachment anxiety, ECR-RD12-attachment avoidance, and ECR-RD12-insecure adult attachment were examined via logistic regression analyses.
RESULTS: Suicidal ideation was present in 13% of all patients. ECR-RD12-anxiety was significantly associated with suicidal ideation (OR = 1.88, CI 1.44-2.44), while ECR-RD12-avoidance was not associated. In patients with suicidal ideation, 85% were insecurely attached compared to 63% in those without suicidal ideation - thus the OR for suicidal ideation in insecurely attached patients was 3.33 (CI = 1.10-10.04) with securely attached patients as reference. Further variables associated with suicidal ideation were depressive symptomatology, living alone (especially in men) and obesity (especially in women).
LIMITATIONS: The study was cross-sectional in design, and suicidal ideation was assessed using a single item self-report measure.
CONCLUSION: General practitioners should be aware of attachment styles in order to have a better chance to identify patients at risk for suicide.