年轻男男性行为人群自杀意念及相关因素的随访研究

A follow-up study of suicidal ideation and related factors among young men who have sex with men

目的:了解年轻男男性行为人群(YMSM)自杀意念的发展轨迹特征及其相关因素。方法:于2017年9月-2018年1月招募YMSM515例,分别于2018年7-9月、2019年6-7月、2020年10-12月完成随访调查。采用歧视感知量表、心理韧性量表(CD-RISC-10)和领悟社会支持量表(PSSS)分别测量因性取向而感受到的歧视、心理韧性和社会支持水平。本次纳入分析的YMSM有448例,采用轨迹分析模型(GBTM)分析自杀意念发展轨迹的异质性。结果:三次随访显示,分别有16.7%、20.3%、15.6%的YMSM在过去6个月内曾有过自杀意念。GBTM模型将样本分为持续性低自杀意念风险组(86.4%)和持续性高自杀意念风险组(13.6%)。Logistic回归分析显示,不认同自身生理性别(OR=4.69)、向同性恋朋友出柜(OR=2.89)、歧视感知程度高(OR=3.30)的YMSM更可能表现为持续性高自杀意念。年龄更大(OR=0.84)、心理韧性(OR=0.24)及社会支持(OR=0.16)等级高的YMSM较小可能表现为持续性高自杀意念。结论:YMSM年轻男男性行为人群自杀意念存在不同的发展轨迹,较低年龄、具有性别认同问题、向同性恋朋友出柜、歧视感知程度高易出现持续性高自杀意念。

Objective:To explore the developing trajectory of suicidal ideation and associated factors among young men who have sex with men(YMSM).Methods:Totally 515 YMSM were recruited from September 2017 to January 2018 and completed 3 follow-up surveys at July to September 2018,June to July 2019,October to De-cember 2020,respectively.The China MSM Stigma Scale,Cornor-Davidson resilience scale(CD-RISC-10)and Perceived Social Support Scale(PSSS)were implemented to evaluate perceived discrimination due to sexual orien-tation,resilience,and social support respectively.The group-based trajectory modeling(GBTM)was used to identify the heterogeneity of suicidal ideation developing trajectories among 448 YMSM.Results:Three waves follow-up surveys showed that 16.7%,20.3%and 15.6%of YMSM had suicidal ideation in the past 6 months,respective-ly.Two groups were identified by GBTM:consistently low suicidal ideation(86.4%)and consistently high suicidal ideation(13.6%).Logistic regression analysis showed that YMSM who didn't identify with their physiological gender(OR=4.69),came out to gay friends(OR=2.89)with high perceived discrimination(OR=3.30)were more likely to be consistently high suicidal ideation.The older(OR=0.84)with high resilience(OR=0.24)and social support(OR=0.16)were less likely to be consistently high suicidal ideation.Conclusion:There are different developing trajectories of suicidal ideation among Y MSM Those younger,disturbed by gender identity,have come out to gay friends with high perceived discrimination are prone to consistently high suicidal ideation.