青少年抑郁症住院病人非自杀性自伤行为现状及危险因素的分析  

Analysis of the current status and risk factors for non-suicidal self-injury behavior in hospitalized adolescent depressive disorder patients

作　　者：李燕婷 韩柏[2,3] 王彦芳 LI Yanting;HAN Bai;WANG Yanfang(The First Clinical Medical College of Shanxi Medical University,Taiyuan,Shanxi 030001,China;Department of Psychiatry,First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China;Department of Psychiatric Prevention,Ping'an Hospital,Xicheng District,Beijing 100055,China)

机构地区：[1]山西医科大学第一临床医学院,山西太原030001 [2]山西医科大学第一医院精神科,山西太原030001 [3]北京市西城区平安医院精防科,北京100055

出　　处：《安徽医药》2023年第10期1975-1980,共6页Anhui Medical and Pharmaceutical Journal

基　　金：国家重点研发计划(2016YFC1307103);山西省136兴医工程项目。

摘　　要：目的探究住院抑郁症青少年非自杀性自伤行为的现状及其相关的风险因素。方法纳入2021年9月至2022年1月于山西医科大学第一医院住院治疗的首发中重度青少年抑郁症病人120例,分为无自伤自杀行为组(n=29),非自杀性自伤(non-suicidal self-injury,NSSI)组(n=65),自杀未遂(suicide attempt,SA)组(n=26)。使用自制调查表收集一般资料;汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)-24评估病人的情绪状态;使用自尊量表(SES),艾森克人格问卷(EPQ)、儿童期虐待问卷(CTQ)、青少年生活事件量表(ASLEC)、网络成瘾测试(IAT)评估病人的社会心理因素。结果无自伤自杀行为组、NSSI组、SA组抑郁、焦虑的得分逐渐增高,SA组HAMD与HAMA得分高于无自伤自杀行为组[(27.6±4.54)分比(22.83±4.80)分;(20.3±4.14)分比(17.21±4.60)分,均P<0.05];NSSI组和SA组CTQ总分、情感虐待、躯体虐待、情感忽视、神经质、精神质、ASLEC总分、人际关系、受惩罚、IAT得分高于无自伤自杀行为组;NSSI组及SA组内外向及SES得分显著低于无自伤自杀行为组[(37.33±3.10)分比(35.98±2.34)分比(39.70±3.37)分;22.00(18.50,24.00)分比17.50(15.00,22.00)分比26.00(23.00,29.50)分,均P<0.001)];SA组躯体虐待、情感忽视、其他、IAT得分高于NSSI组[(9.00(8.00,10.25)分比8.00(7.00,9.00)分;14.50(13.00,17.00)分比13.00(12.00,14.00)分;8.00(7.00,10.00)分比6.00(6.00,8.00)分;55.00(54.00,56.00)分比53.00(51.00,54.00)分,均P<0.001)];NSSI组学习压力得分高于无自伤自杀行为组[(11.68±5.29)分比(8.72±5.33)分,P<0.05],以上均差异有统计学意义(P<0.05)。logistic回归分析显示精神质、IAT为NSSI的危险因素,SES为保护性因素。结论青少年抑郁症病人NSSI行为的患病率较高,精神质、网络成瘾是自伤自杀行为的危险因素,自尊的程度是保护因素。Objective To investigate the current status of non-suicidal self-injurious behavior in hospitalized adolescents with major depressive disorder and its associated risk factors.Methods A total of 120 hospitalized adolescent patients with first-episode moderate to severe depression were enrolled in The First Hospital of Shanxi Medical University from September 2021 to January 2022.They were divided into the no self-injurious suicidal behavior group(n=29),NSSI group(n=65),and SA group(n=26).We used a self-made questionnaire to collect the general information.The Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale(HAMD)-24 were used to assess the emotional state of patients.The self-esteem scale(SES),the Eysenck Personality Questionnaire(EPQ),the Childhood Abuse Questionnaire(CTQ),the Adolescent Life Events Scale(ASLEC),and the Internet Addiction Test(IAT)were used to assess psychosocial factors.Results The scores of depression and anxiety in the no self-injurious suicidal behavior group,NSSI group and SA group were gradually increased,and the scores of the HAMD-24 and HAMA were higher in the SA group than in the no self-injurious suicidal behavior group[(27.6±4.54)score vs.(22.83±4.80)score,(20.3±4.14)score vs.(17.21±4.60)score,P<0.05].The NSSI and SA groups had higher scores for CTQ,emotional abuse,physical abuse,emotional neglect,neuroticism,psychoticism,ASLEC total scores,interpersonal relationships,punishment,and IAT than the no self-injurious suicidal behavior group.The NSSI group and SA groups had significantly lower scores for extroversion and SES than the no self-injurious suicidal behavior group[(37.33±3.10)score vs.(35.98±2.34)score vs.(39.70±3.37)score;22.00(18.50,24.00)score vs.17.50(15.00,22.00)score vs.26.00(23.00,29.50)score,P<0.001].The SA group had higher scores for physical abuse,emotional neglect,others and IAT than the NSSI group[9.00(8.00~10.25)score vs.8.00(7.00,9.00)score;14.50(13.00,17.00)score vs.13.00(12.00,14.00)score;8.00(7.00,10.00)score vs.6.00(6.00,8.00)score;55.00(54.0

关 键 词：抑郁症 青少年 精神质 网络成瘾 非自杀性自伤行为 危险因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]