Citation

Rückert-Eheberg IM, Lukaschek K, Brenk-Franz K, Strauß B, Gensichen J. J. Affect. Disord. 2018; 246: 121-125.

Affiliation

Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Pettenkoferstr. 8a/10, D-80336 Munich, Germany; Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University, Bachstr. 18, D-07743 Jena, Germany.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.jad.2018.12.029

PMID

30580197

Abstract

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.

Copyright © 2018 Elsevier B.V. All rights reserved.

Language: en

Keywords

Cross-sectional study; Insecure attachment; Primary health care; Suicidal ideation