新型冠状病毒肺炎患者自杀风险、睡眠、心理状况及影响因素  

Poor sleep quality,anxiety and depression are associated with an increased suicide risk in patients with coronavirus disease 2019

作　　者：王汝杰 李静[1] 梅俊华[2] 肖明朝[3] 况利[1] 宋波 王亮[4] 龚雪 王婧[2] 尚雅楠[1] 曹婉 龙香花 杨显娟 魏玲[6] 张帆 吴祖勤 彭诗月 秦赟 WANG Rujie;LI Jing;MEI Junhua;XIAO Mingzhao;KUANG Li;SONG Bo;WANG Liang;GONG Xue;WANG Jing;SHANG Yanan;CAO Wan;LONG Xianghua;YANG Xianjuan;WEI Ling;ZHANG Fan;WU Zuqin;PENG Shiyue;QIN Yun(Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016;Department of Neurology,First Hospital of Wuhan City,Wuhan,Hubei Province,430022;the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016;Department of Neurology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016;Sleeping and Psychosomatic Center,Dazu District People’s Hospital,Chongqing,402360;Second Ward of Psychiatry,Zigong Mental Health Center,Zigong,Sichuan Province,643020;Department of Psychology,Shaanxi Nuclear Geology 215 Hospital,Xianyang,Shaanxi Province,712000;Academic Affairs Department,the Second Affiliated Hospital of Chongqing Medical University,Chongqing,400010;First Psychogeriatric Ward,Gele Mountain Hospital of Chongqing Mental Health Center,Chongqing,400036;Second Ward of Early Intervention,Jinzi Mountain Hospital of Chongqing Mental Health Center,Chongqing,401147,China)

机构地区：[1]重庆医科大学附属第一医院精神科,重庆400016 [2]武汉市第一医院神经内科,武汉430022 [3]重庆医科大学附属第一医院,重庆400016 [4]重庆医科大学附属第一医院神经内科,重庆400016 [5]重庆市大足区人民医院睡眠心身中心,重庆402360 [6]自贡市精神卫生中心精神科二病区,四川自贡643020 [7]陕西省核工业二一五医院精神心理科,陕西咸阳712000 [8]重庆医科大学附属第二医院教务处,重庆400010 [9]重庆市精神卫生中心歌乐山院区老年一科,重庆400036 [10]重庆市精神卫生中心金紫山院区早期干预二科,重庆401147

出　　处：《第三军医大学学报》2020年第14期1462-1468,共7页Journal of Third Military Medical University

摘　　要：目的探讨新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者自杀风险、睡眠、心理状况及影响因素。方法收集2020年1月2日至2020年3月10日COVID-19住院患者和非COVID-19人群。感染组:376人(男性95人,女性281人),为COVID-19住院患者。对照组:501人(男性110人,女性391人),来自于基于微信、公众平台、朋友圈等的非COVID-19人群。采用线上和线下、自评结合精神科医师评估的方式进行调查。采用风险评估量表(the Nurses’Global Assessment of Suicide Risk Scale,NGASR)、匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、抑郁自评量表(Self-rating Depression Scale,SDS)进行评估。对感染组和对照组年龄、自杀风险总分、PSQI总分及各因子分、SAS总分、SDS总分进行独立样本t检验;对两组性别、躯体疾病史、目前所在城市进行χ2检验,两组自杀风险、睡眠问题、焦虑、抑郁发生率比较和重度及以上自杀风险、睡眠问题、焦虑、抑郁发生率比较进行χ2检验;对感染组自杀风险总分、年龄、SAS总分、SDS总分、PSQI总分及各因子分进行Pearson相关分析;以感染组自杀风险总分为应变量,感染组性别、年龄、躯体疾病史、SDS总分、SAS总分、PSQI总分为自变量进行多元线性回归(stepwise法)分析。应用SPSS 22.0软件完成数据统计。结果①感染组中度及以上自杀风险、睡眠质量差、焦虑、抑郁发生率分别为27.39%、63.03%、31.91%、54.26%,对照组中度及以上自杀风险、睡眠质量差、焦虑、抑郁发生率分别为7.98%、33.53%、9.18%、21.36%,差异有统计学意义(P<0.01)。感染组高自杀和极高自杀风险、睡眠质量很差、重度和极重度焦虑、重度和极重度抑郁发生率分别为9.57%、12.23%、4.79%、7.98%,对照组高自杀和极高自杀风险、睡眠质量很差、重度和极重度焦虑、重度和极重度抑郁发生率分别�Objective To evaluate suicide risk,sleep quality and psychological status of patients with coronavirus disease 2019(COVID-19)and analyze the factors contributing to a high suicide risk in these patients.Methods This study was conducted in a cohort of 376 COVID-19 patients(including 95 male and 281 female patients)hospitalized between January 2 and March 10,2020,with 501 subjects without COVID-19(including 110 men and 391 women)recruited from different social media platforms as the control group.All the subjects were evaluated by online or face-to-face interview with either self-administered rating or assessment of psychiatrists using the Nurses’Global Assessment of Suicide Risk scale(NGASR),Pittsburgh Sleep Quality Index(PSQI),Self-rating Anxiety Scale(SAS),and Self-rating Depression Scale(SDS).The patients’age,the total score of suicide risk,total scores of PSQI,SAS,and SDS,and the factor scores of PSQI were compared between the case group and the control group.Chi-square test was used to compare gender distribution,history of physical illness,residence,suicide risks,sleep problems,anxiety,and depression between the 2 groups.Correlation analysis was performed for the patients’age,total score of suicide risk,total scores of SAS,SDS,PSQI and factor score of PSQI in the case group.Stepwise multiple linear regression analysis was used to identify the risk factors associated with suicide risk in the patients with the total score of suicide risk as the dependent variable and gender,age,physical disease history,total scores of SDS,SAS and PSQI,and the factor score of PSQI as the independent variables.Results①In the patients with COVID-19,the incidences of a moderate or higher suicide risk,poor sleep quality,anxiety and depression were 27.39%,63.03%,31.91%,and 54.26%,respectively,significantly higher than those in the control group(7.98%,33.53%,9.18%and 21.36%,respectively;P<0.01).The rates of high and very high suicide risk,severe sleep problems,severe or extremely severe anxiety,and severe or extremely severe

关 键 词：新型冠状病毒肺炎 自杀风险 睡眠 焦虑 抑郁 影响因素 

分 类 号：R181.32[医药卫生—流行病学] R395.2[医药卫生—公共卫生与预防医学]