伴与不伴焦虑症状抑郁症患者的自杀风险  

Risk factors of suicidality in major depressive disorder patients with and without anxious characteristics

作　　者：辛立敏[1,2] 陈林[2] 吉振鹏 张索远 王君[2] 刘艳红[2] 陈大方[3] 杨甫德[2] 王刚[4] 方贻儒[5] 陆铮[6] 杨海晨 胡建[8] 陈致宇 黄颐 孙静[11] 王小平 李惠春[13] 张晋碚[14] 司天梅[1] 

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),北京100191 [2]北京回龙观医院,北京100096 [3]北京大学医学部公共卫生学院,北京100191 [4]首都医科大学附属北京安定医院情感障碍中心,北京100088 [5]上海交通大学附属精神卫生中心心境障碍科,上海200030 [6]上海同济大学附属同济医院精神医学科,上海200065 [7]深圳精神卫生中心情感障碍科,广东深圳518020 [8]哈尔滨医科大学附属第一医院,哈尔滨150001 [9]杭州第七人民医院,杭州310007 [10]西川大学华西医院心理卫生中心,成都610041 [11]南京医科大学附属脑科医院,南京210029 [12]湖南湘雅二院精神卫生研究所,长沙410011 [13]浙江大学医学院附属第二医院精神科,杭州310009 [14]中山大学附属第三医院心理科,广州510630

出　　处：《中国心理卫生杂志》2015年第11期812-816,共5页Chinese Mental Health Journal

摘　　要：目的:比较伴与不伴焦虑症状抑郁症患者的自杀风险,分析抑郁症患者自杀风险的危险因素。方法:对2010年9月1日至2011年2月28日"中国双相情感障碍患者诊断评估服务"研究项目的数据进行二次分析,纳入分析的抑郁症患者共1172例,根据简明国际神经精神访谈(M.I.N.I)焦虑模块,分为伴焦虑症状抑郁症组728例(62.1%)及不伴焦虑症状组444例(37.9%)。采用M.I.N.I自杀模块评估自杀风险,比较伴与不伴焦虑症状抑郁症患者的自杀风险,通过logistic回归分析探讨抑郁症患者自杀风险的相关因素。结果:伴焦虑症状抑郁症患者中有自杀风险者331例(45.5%);不伴焦虑症状者中有自杀风险者54例(12.2%)。与不伴焦虑症状抑郁症患者比较,伴焦虑症状者自杀风险更高(P<0.001)。Logistic回归分析显示,抑郁发作频繁(OR=2.07)、伴精神病性症状(OR=2.01)、伴焦虑症状(OR=3.18)、伴忧郁型特征(OR=2.90)与抑郁症患者的自杀风险相关。结论:伴焦虑症状抑郁症患者可能有更高的自杀风险。发作频繁、伴精神病性症状、伴焦虑症状或伴忧郁型特征可能是抑郁症患者自杀风险的危险因素。Objective： To compare the suicidality risk in major depressive disorder（ MDD） patients with and without anxious characteristics,and analyze the risk factors of suicidality in MDD patients. Methods： This was a secondary analysis of the data from the Diagnostic Assessment Service for people with Bipolar Disorders in China（ DASP）,which was initiated by the Chinese Society of Psychiatry（ CSP）,from September 1,2010 to February 28,2011. Based on the anxious module and suicide module of Mini International Neuropsychiatric Interview（ M. I. N. I）,1172 MDD patients were classified as suffering from anxious MDD（ n = 728,62. 1%） and non-anxious MDD（ n = 444,37. 9%）. Logistic regression was employed to examine the risk factors of suicidality in MDD patients. Results： Among the anxious MDD patients,331（ 45. 5%） of them had suicidality risk. And 54（ 12. 2%） of non-anxious MDD patients had suicidality risk. Compare to the non-anxious group,the anxious MDD patients had significantly higher suicidality risk（ P〈0. 001）. Logistic regression analysis showed that more frequent depressive episodes（ OR = 2. 07）,depressive episodes with psychotic symptoms（ OR = 2. 01）,comorbid with anxious characteristics（ OR = 3. 18） or melancholic characteristics（ OR = 2. 90） were associated with suicidality risk in patients with MDD. Conclusion： It indicates that the anxious MDD patients may have higher suicidality risk than non-anxious MDD patients,and more frequent depressive episodes,depressive episodes with psychotic symptoms,comorbid with anxious characteristics or melancholic characteristics may be risk factors of suicidality in patients with MDD.

关 键 词：抑郁症 焦虑症状 自杀风险 危险因素 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R749.72[医药卫生—临床医学]