Suicidal ideation is the most proximal risk factor for
suicide and can indicate extreme psychological distress; identification of its
predictors is important for possible intervention. Depression and stressful or
traumatic life events (STLEs), which are more common among HIV-infected
individuals than the general population, may serve as triggers for suicidal
thoughts.
A randomized controlled trial testing the effect of
evidence-based decision support for depression treatment on antiretroviral
adherence (the SLAM DUNC study) included monthly assessments of incident STLEs,
and quarterly assessments of suicidal ideation (SI). We examined the
association between STLEs and SI during up to one year of follow-up among 289
Southeastern US-based participants active in the study between 7/1/2011 and
4/1/2014, accounting for time-varying confounding by depressive severity with
the use of marginal structural models.
Participants were mostly male (70%) and black (62%), with a
median age of 45 years, and experienced a mean of 2.36 total STLEs (range:
0-12) and 0.48 severe STLEs (range: 0-3) per month. Every additional STLE was
associated with an increase in SI prevalence of 7% (prevalence ratio (PR) (95%
confidence interval (CI)): 1.07 (1.00, 1.14)), and every additional severe STLE
with an increase in SI prevalence of 19% (RR (95% CI): 1.19 (1.00, 1.42)).
There was a substantial amount of missing data and the
exposures and outcomes were obtained via self-report; methods were tailored to
address these potential limitations.
STLEs were associated with increased SI prevalence, which is
an important risk factor for suicide attempts and completions.
Purchase full article at: http://goo.gl/5zAZYW
By:
- 1University of North Carolina at Chapel Hill, Department of Epidemiology, United States. Electronic address: julie.k.odonnell@gmail.com.
- 2University of North Carolina at Chapel Hill School of Medicine, Department of Psychiatry, United States.
- 3University of North Carolina at Chapel Hill, Department of Epidemiology, United States.
- 4Duke University, Center for Health Policy, Duke Global Health Institute, United States.
- 5University of North Carolina at Chapel Hill, Institute for Global Health, Infectious Diseases and Center for AIDS Research, United States.
- 6Duke University School of Medicine, Department of Psychiatry, United States.
- 7University of North Carolina at Chapel Hill, Institute for Global Health and Infectious Diseases, United States.
- 8University of Alabama at Birmingham, Division of Infectious Diseases, United States.
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