青少年抑郁症患者非自杀性自伤行为风险预测模型的构建与评估  

Construction and evaluation of risk prediction model of non-suicidal self-injury behaviors in adolescents with depression

作　　者：杨柳[1] 刘玉山[1] 吴宁渤[1] 孙静[1] YANG Liu;LIU Yushan;WU Ningbo(The First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院,河北秦皇岛066000

出　　处：《精神医学杂志》2022年第5期486-491,共6页Journal of Psychiatry

基　　金：河北省医学科学研究课题计划项目(编号:20191877);秦皇岛市科学技术研究与发展计划项目(编号:202004A094)。

摘　　要：目的探究青少年抑郁症患者非自杀性自伤(NSSI)行为发生的影响因素,建立列线图风险预测模型。方法选取青少年抑郁症患者287例,对患者的一般资料进行调查问卷,并采用NSSI行为问卷评估患者NSSI行为,计算过去1年内NSSI发生率;将患者分为伴NSSI行为组与不伴NSSI行为组,筛选影响NSSI发生的危险因素,建立青少年抑郁症患者NSSI行为发生风险的列线图预测模型,并进行模型评估。结果287例青少年抑郁症患者近1年内NSSI行为发生率为40.07%,自伤方式中占比最高的为“故意割伤自己”67.83%;单因素分析显示,伴NSSI行为组学习日不住校、被有意排挤或孤立、有自杀未遂史、有自杀意念、父亲受教育程度高中/中专占比均高于不伴NSSI行为组(P<0.05),FACESⅡ-CV适应性评分低于不伴NSSI行为组(P<0.05);多因素Logistic回归分析显示,学习日不住校、被有意排挤或孤立、有自杀意念、父亲受教育程度高中/中专、FACESⅡ-CV适应性评分低是青少年抑郁症患者NSSI行为发生的独立危险因素(P<0.05);列线图模型的校准曲线预测值与实际值基本一致,受试者工作特征(ROC)曲线下面积为0.805(95%CI:0.753~0.856)。结论基于青少年抑郁症患者NSSI行为发生的危险因素建立的列线图预测模型具有良好的精准度与区分度,可为预防青少年抑郁症患者发生NSSI行为提供参考价值。Objective To explore the influencing factors of non-suicidal self-injury(NSSI)behaviors in adolescents with depression and establish a nomogram risk prediction model.Methods A total of 287 adolescents with depression were selected and assessed with general information questionnaire,NSSI behavior questionnaire to calculate the incidence rates of NSSI in the past year.The patients were divided into NSSI group and non-NSSI group,to screen the risk factors affecting the occurrence of NSSI,and to establish a nomogram prediction model for the risk of NSSI behaviors in adolescents with depression.Results The incidence rate of NSSI behaviors in 287 adolescents with depression in the past year was 40.07%,and the self-injury behavior with the highest proportion was“intentional cuts”(67.83%).Univariate analysis showed that the proportions of adolescents who were not resident students,being deliberately excluded or isolated,having a history of attempted suicide,having suicidal ideation,and whose fathers’educational level was senior high school/technical secondary school in NSSI group were higher than those in non-NSSI group(P<0.05),and the adaptability score of FACESⅡ-CV in NSSI group was lower than that in non-NSSI group(P<0.05).Multivariate logistic regression analysis showed that living off campus,being deliberately excluded or isolated,having suicidal ideation,father’s educational level being senior high school/technical secondary school,and low adaptability score of FACESⅡ-CV were independent risk factors for the occurrence of NSSI behavior in adolescents with depression(P<0.05).The predicted value of the calibration curve of the nomogram model was basically consistent with the actual value,and the area under the receiver operating characteristic(ROC)curve was 0.805(95 CI:0.753~0.856).Conclusion The nomogram prediction model based on the risk factors of NSSI behavior in adolescents with depression has good accuracy and discrimination,and can provide a certain reference value for preventing NSSI behavior in a

关 键 词：青少年抑郁症 非自杀性自伤行为 影响因素 列线图 

分 类 号：R749.4[医药卫生—神经病学与精神病学]