双相障碍患者自杀相关因素分析  

Analysis of suicide related factors in patients with bipolar disorder

作　　者：杨蕾 王中刚[2] 张云[2] 胡丹丹 张金响[2] YANG Lei;WANG Zhonggang;ZHANG Yun(Jining Medical University,Jining 272067,China)

机构地区：[1]济宁医学院,济宁272067 [2]济宁市精神病防治院

出　　处：《国际精神病学杂志》2020年第6期1148-1152,共5页Journal Of International Psychiatry

基　　金：济宁市科技发展计划项目(编号:2015-73);山东省医药卫生科技发展计划项目(编号:2015WS0423)。

摘　　要：目的本文回顾性比较有和无自杀行为的双相障碍(BD)患者的人口学资料和临床特征资料,分析双相障碍患者自杀行为的相关因素及主要危险因素。方法依据ICD-10诊断标准连续入组2018年1月~2018年12月住院的双相障碍患者共543例,根据是否伴有自杀行为,将患者分为自杀组(n=242例)和非自杀组(n=301例),比较分析其人口学和临床特征资料,通过Logistic回归分析探讨双相障碍患者自杀行为的主要危险因素。结果与非自杀组相比,自杀组双相障碍患者女性(χ^(2)=-3.375,P=0.001)、既往发作次数、首发抑郁症状(χ^(2)=24.522,P=0.000)、有精神刺激(χ^(2)=14.496,P=0.000)、伴妄想性质的精神病性症状(χ^(2)=-2.267,P=0.023)差异有统计学意义(P值均<0.05)。多因素Logistic回归分析显示,女性(OR:1.79,95%CI:1.252-2.557)、首发抑郁症状(OR:2.288,95%CI:1.549-3.379)、既往抑郁发作次数(OR:1.23,95%CI:1.124-1.345)与双相障碍自杀风险因素相关(P均<0.05)。结论女性、抑郁首发、既往抑郁发作频繁可能是双相障碍患者自杀行为的独立危险因素,重点关注其危险因素对预防自杀有重要意义。Objective To compare the demographic data and clinical characteristics of bipolar disorder(BD) patients with and without suicidal ideation/behavior,and analyze the related factors and main risk factors of suicidal ideation/behavior in bipolar disorder patients. Methods From January 2018 to December 2018 in our hospital,a total of 543 patients with bipolar disorder,according to whether with suicidal behavior,divided the patients into suicide group(n=242)and the no suicide group(n=301),the comparative analysis of the demographic and clinical characteristics of the data,by Logistic regression analysis on patients with bipolar disorder a major risk factor for suicidal behavior. Results Compared with the non-suicidal group,the majority of women in the suicidal group had bipolar disorder(χ^(2)=-3.375,P=0.001),previous episodes,first depressive symptoms(χ^(2)=24.522,P=0.000),mental stimulation(χ^(2)=14.496,P=0.000),psychiatric symptoms with delusional nature [138(65.40)vs.173(74.60),χ^(2)=-2.267,P=0.023] were statistically significant(all P values were<0.05). Multivariate Logistic regression analysis showed that in females(OR :1.79,95%CI :1.252~2.557),first depressive symptoms(OR :2.288,95%CI :1.549~3.379),psychotic symptoms with delusion(OR :1.551,95%CI :1.03~2.336),and number of previous depressive episodes(OR :1.23,95% CI :1.124~1.345)were associated with suicide risk factors for bipolar disorder(all P< 0.05). Conclusion Female,depressive episode and the more depressive episodes you have may be independent risk factors for suicidal ideation/behavior in patients with bipolar disorder.

关 键 词：双相情感障碍 自杀 自杀行为 临床特征 

分 类 号：R749.4[医药卫生—神经病学与精神病学]