METHODS: Between March and April 2020, old adults diagnosed with major depressive disorder (single or recurrent episode) as defined by the DSM-5 were recruited from psychiatric clinics or inpatient wards, whereas 31 healthy older adults without a history of depression or other psychiatric illnesses were recruited from voluntary organisations or elderly community centres. Their depressive symptoms, perceived severity of the pandemic, perceived time spent on receiving related information, perceived health, levels of loneliness, perceived coping efficacy, suicidal ideation, and the level of symptomatic responses to a specific traumatic stressor in the past week were assessed.
RESULTS: In total, 21 men and 43 women aged 61 to 89 years were interviewed through telephone by trained research assistants. Of them, 33 were older adults with LLD (cases) and 31 were healthy older adults (controls). Older people with LLD had a higher level of suicidal ideation than healthy controls, after controlling for the level of depression and medical comorbidity (F (1, 59) = 5.72, p = 0.020). Regression analyses showed that coping efficacy and loneliness accounted for a significant portion of the variance in suicidal ideation, and loneliness significantly predicted the level of stress. Mediation analyses reveal an indirect effect between group and suicidal ideation through coping efficacy (Z = 2.43, p = 0.015).
CONCLUSIONS: Older people with LLD are at increased suicidal risk and require timely mental health support. Coping efficacy and loneliness are important predictors for suicidal ideation and stress.
方法:在2020年3月至4月之间,根据DSM-5定义,被诊断患有重度抑郁症(单次或复发性发作)的老年人从精神科诊所或住院病房招募,而从志愿组织或老年社区中心招募了31名没有抑郁症或其他精神疾病史的健康老年人。他们的抑郁症状,认为大流行的严重程度,接收相关信息所花费的感知时间,感知健康,孤独的程度,感知应对效能,自杀意念,并评估了过去一周对特定创伤应激源的症状反应水平.
结果:总计,21名年龄在61至89岁之间的男性和43名女性接受了训练有素的研究助理的电话采访。其中,33名是患有LLD的老年人(病例),31名是健康的老年人(对照)。患有LLD的老年人的自杀意念水平高于健康对照组,在控制抑郁和医学共病水平后(F(1,59)=5.72,p=0.020)。回归分析表明,应对效能和孤独感占自杀意念差异的显着部分,孤独感显著预测了压力水平。中介分析揭示了群体和自杀意念之间通过应对功效的间接影响(Z=2.43,p=0.015)。
结论:患有LLD的老年人自杀风险增加,需要及时的心理健康支持。应对效能和孤独感是自杀意念和压力的重要预测因子。