人际关系对青少年抑郁症患者非自杀性自伤行为的影响  

The Influence of Interpersonal Relationship on Non-suicidal Self-injury Behavior in Adoles⁃cents with Depression

作　　者：向均怡 金柳荫 钱红[1] 王高华[1] 舒畅[1] XIANG Jun-yi;JIN Liu-yin;QIAN Hong;WANG Gao-hua;SHU Chang(Department of Psychiatry,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院精神卫生中心,武汉430060

出　　处：《神经损伤与功能重建》2022年第8期444-448,共5页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨人际关系对首次发病青少年抑郁症患者非自杀性自伤行为(NSSI)的影响。方法:纳入80例青少年抑郁症患者,采用青少年自我伤害问卷进行评估,根据有无NSSI,将患者分为伴NSSI组和不伴NSSI组。所有入组对象采用汉密尔顿抑郁量表-17项(HAMD-17)、汉密尔顿焦虑量表(HAMA)评估抑郁及焦虑症状;采用亲子亲密度量表、同伴关系量表、师生关系量表评估样本的人际关系情况,并进行组间比较。采用二元Logistic回归分析人际关系中NSSI的独立风险因素;采用Pearson相关分析分析各变量之间的相关程度。结果:纳入伴NSSI组42例(52.5%),不伴NSSI组38例(47.5%)。与不伴NSSI组相比较,伴NSSI组在HAMD-17、HAMA、同伴恐怖自卑、师生关系冲突性方面得分更高(均P<0.01),在亲子亲密度、父亲亲密度、母亲亲密度、同伴关系总分、同伴接受、师生关系亲密性、师生关系支持性、师生关系满意度方面得分更低(均P<0.01或P<0.05)。Logistic回归分析显示同伴接受、同伴恐怖自卑、父亲亲密度及母亲亲密度为NSSI的独立风险因素。Pearson相关分析显示,伴NSSI组的NSSI得分与母亲亲密度呈负相关(P<0.01)。HAMD-17及HAMA得分与NSSI得分呈正相关(P<0.05或P<0.01),与师生关系冲突性、同伴恐怖自卑呈正相关(P<0.05或P<0.01)。在HAMD-17的各项因子与指标中,焦虑/躯体化因子与同伴恐怖自卑及NSSI得分呈正相关(均P<0.01);认知障碍因子与师生关系冲突性及NSSI得分呈正相关(均P<0.05),且与师生关系亲密度、父亲亲密度、母亲亲密度呈负相关(均P<0.05);迟缓因子则与师生关系冲突性以及同伴恐怖自卑呈正相关(均P<0.05)。结论:青少年抑郁症患者NSSI行为发生率较高,且与人际关系有关,不良的师生关系、同伴关系和亲子关系,更容易导致出现NSSI行为。Objective:To investigate the effect of interpersonal relationships on non-suicidal self-injury(NSSI)in adolescents with first episode depression.Methods:Eighty adolescent patients with first episode depression were enrolled and evaluated by the adolescent self-injury questionnaire for NSSI.According to the presence or absence of NSSI,patients were divided into NSSI group and no-NSSI group.All subjects were assessed with Hamilton Depression Scale(HAMD-17)and Hamilton Anxiety Scale(HAMA)for depression and anxiety symp-toms.Parent-child intimacy scale,peer relationship scale,and teacher-student relationship scale were used to evaluate the interpersonal relationship of the samples,and an inter-group comparison was conducted.The inde-pendent risk factors of interpersonal relationships for NSSI were analyzed by binary Logistic regression.Pearson correlation analysis was used to analyze the relationship between NSSI and interpersonal relationships.Re⁃sults:42 cases(52.5%)were enrolled NSSI group and 38 cases(47.5%)in no-NSSI group.Compared with the no-NSSI group,cases in the NSSI group scored higher in HAMD-17,HAMA,peer terror inferiority complex,and conflict of teacher-student relationship(all P<0.01),and lower in parent-child intimacy,father intimacy,mother intimacy,the total score of peer relationship,peer acceptance,intimacy of teacher-student relationship,support of teacher-student relationship and satisfaction of teacher-student relationship(all P<0.01 or P<0.05).Lo-gistic regression analysis showed that peer acceptance,peer fear and inferiority,father intimacy,and mother inti-macy were independent risk factors of NSSI.Pearson correlation analysis showed a negative correlation between NSSI score and maternal intimacy in the NSSI group(P<0.01).HAMD-17 and HAMA scores were positively correlated with NSSI scores(P<0.05 or P<0.01),conflict between teachers and students,peer terror and inferiori-ty complex(P<0.05 or P<0.01).Among the factors and indexes of HAMD-17,the anxiety/somatization factor was positively correl

关 键 词：抑郁症 非自杀性自伤 人际关系 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学] R749