青少年抑郁症住院患者自杀行为发生率及其相关风险因素分析  

Study on the incidence of suicidal behavior and related risk factors in adolescents with depression

作　　者：彭婉嫕 邓金平 刘惟蜻 冀二妮[1] 何红波 Peng Wanyi;Deng Jinping;Liu Weiqing;Ji Erni;He Hongbo(Shenzhen Mental Health Center/Shenzhen Kangning Hospital,Shenzhen 518000,China;Guangdong General Hospital/Guangdong Provincial Mental Health Center,Guangzhou 510120,China)

机构地区：[1]深圳市精神卫生中心、深圳市康宁医院,深圳518000 [2]广东省人民医院、广东省精神卫生中心,广州510120

出　　处：《中华精神科杂志》2024年第1期33-40,共8页Chinese Journal of Psychiatry

基　　金：广东省高水平临床重点专科(SZGSP013);深圳市医学重点学科建设经费(SZXK043);广州市卫生健康科技项目(2022A0310030)。

摘　　要：目的探究青少年抑郁症住院患者的自杀行为发生率及其相关风险因素。方法回顾性分析2016年1月至2022年12月深圳市康宁医院收治的442例青少年抑郁症住院患者的病例资料,男64例,女358例,年龄10~17岁。以入院当天的简明国际神经精神访谈(International Neuropsychiatric Interview,MINI)自杀模块评估结果为指标,根据既往1个月内是否有自杀行为分为自杀未遂组(n=140)和非自杀未遂组(n=302)。比较2组患者的社会人口特征、临床特征、内分泌指标及艾森克个性测验(Eysenck Personality Questionnaire,EPQ)、家庭环境量表简式中文版(The Chinese Version of Family Environment Scale Symptoms Questionnaire,FES-F)、青少年生活事件量表(Adolescent Self-rating Life Events Checklist,ASLEC)、童年期虐待问卷(Childhood Trauma Questionnaire,CTQ)、青少年多维焦虑量表(The Multidimensional Anxiety Scale for Children,MASC)、儿童抑郁量表(Child Depression Inventory,CDI)的评分。使用logistic回归分析近1个月内自杀行为的风险因素。结果青少年抑郁症住院患者入院前1个月内的自杀行为发生率为31.67%(140/442),既往总体自杀行为发生率为53.8%(238/442)。相比非自杀未遂组患者,自杀未遂组患者在精神病性症状、共病躯体疾病、既往有过自杀行为更常见,分别为46%(64/140)比26%(77/302)、34%(47/140)比21%(65/302)、81%(114/140)比32%(98/302)(χ^(2)=18.00、7.34、91.94,均P<0.05)。量表评分方面,自杀未遂组患者比非自杀未遂组患者,ASLEC中的健康适应因子得分更高[M(Q1,Q3)][6(4,9)比5(3,8)](χ^(2)=2.13,P<0.05);MASC中的躯体症状因子得分更高[26(19.25,31)比24(16,29)](χ^(2)=2.50,P<0.05);CDI中的负性情绪、低自尊、人际问题因子得分以及CDI总分评分也更高(χ^(2)=2.35、2.96、2.09、2.17;均P<0.05)。回归分析显示,精神病性症状(OR=1.85,95%CI:1.13~3.02)、共病躯体疾病(OR=1.85,95%CI:1.09~3.14)、既往有过自杀行为(OR=8.34,95%CI:5.01~1Objective To investigate the prevalence of suicidal behaviors and their associated risk factors among adolescent inpatients with depression.Methods A retrospective analysis of the medical records of 442 adolescent inpatients diagnosed with depression at Shenzhen Kangning Hospital from January 2016 to December 2022 was conducted.Among them,64 were male and 358 were female.They range in age from 10 to 17.The MINI suicidal module assessment on the day of admission was employed.Based on the presence or absence of suicidal behavior in the past month,patients were divided into the attempted suicide group(n=140)and the non-attempted suicide group(n=302).Comparative analysis was performed on the sociodemographic characteristics,clinical features,endocrinological indices,and scores from the Eysenck Personality Questionnaire(EPQ),Short Form of the Family Environment Scale(FES-F),Adolescent Self-Rating Life Events Checklist(ASLEC),Childhood Trauma Questionnaire(CTQ),Multidimensional Anxiety Scale for Children(MASC),and Child Depression Inventory(CDI)between the two groups.Logistic regression was utilized to identify risk factors associated with suicidal behavior.Results The prevalence of suicidal behavior in the past month among adolescent inpatients with depression was 31.67%(140/442),and the lifetime prevalence was 53.8%(238/442).Compared to patients in the non-suicidal attempt group,those in the suicidal attempt group showed higher occurrences of psychotic symptoms,comorbid physical diseases,and past suicidal behaviors,respectively,at 46%(64/140)vs 26%(77/302),34%(47/140)vs 21%(65/302),and 81%(114/140)vs 32%(98/302)(χ^(2)=18.00,7.34,91.94;all P<0.05).In terms of scale scores,patients in the suicidal attempt group,compared to those in the non-suicidal attempt group,had higher scores in the health adaptation factor in ASLEC,with[M(Q1,Q3)]6(4,9)vs 5(3,8)(χ^(2)=2.13,P<0.05);higher scores in the somatic symptom factor in MASC,with 26(19.25,31)vs 24(16,29)(χ^(2)=2.50;P<0.05);and higher scores in the negative emotions,low se

关 键 词：抑郁症 青少年 自杀行为 发生率 风险因素 精神病性症状 共病躯体疾病 

分 类 号：R749.4[医药卫生—神经病学与精神病学]