首发未治疗抑郁障碍患者快感缺失与自杀意念的关系  

Relationship between anhedonia and suicidal ideation in patients with first-episode untreated depressive disorder

作　　者：武伟丽 冀紫阳 张清清 辛通通 杜云红[1] WU Weili;JI Ziyang;ZHANG Qingqing;XIN Tongtong;DU Yunbong(The Second Affliated Hospital of Xinxiang Medical University,Henan Province Psychiatric Hospital,Xinxiang 453002,Henan Province,China;Linyi Mental Health Center,Linyi 276005,Shandong Province,China;Xinxiang First People's Hospital,Xinxiang 453000,Henan Province,China)

机构地区：[1]新乡医学院第二附属医院,河南省精神病医院,河南新乡453002 [2]临沂市精神卫生中心,山东临沂276005 [3]新乡市第一人民医院,河南新乡453000

出　　处：《中国心理卫生杂志》2024年第5期383-387,共5页Chinese Mental Health Journal

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220638)。

摘　　要：目的:探讨首发未治疗抑郁障碍患者快感缺失特征与自杀意念的关系。方法:选取106名符合精神障碍诊断与统计手册第5版(DSM-5)诊断标准的抑郁障碍患者,采用斯奈思-汉密尔顿快感量表(SHAPS)评估快感缺失程度、汉密顿抑郁量表(HAMD)评估抑郁症状,采用Beck自杀意念量表(BSI)评估自杀意念,若BSI第4和第5条目均为0分,则为无自杀意念,将研究对象分为有自杀意念组(66例)和无自杀意念组(40例),采用Spearman相关分析和多因素二元logistic回归进行分析。结果:SHAPS得分与HAMD得分的相关无统计学意义(P>0.05),SHAPS得分与BSI得分呈正相关(r=0.70,P<0.01),多因素二元logistic回归分析显示,快感缺失是自杀意念的危险因素(OR=2.34,95%CI:1.58~3.47,P<0.001)。结论:快感缺失可能部分独立于其他抑郁症状,是首发抑郁障碍患者自杀意念的危险因素之一。Objective:To explore the relationship between anhedonia and suicidal ideation and the effects of anhedonia on suicidal ideation in patients with first-episode untreated depressive disorder.Methods:Totally 106 in-patients who met the diagnostic criteria for depressive disorder of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were invited to participate in the study.Anhedonia,depressive symptoms and sui-cidal ideation were assessed with the Snaith-Hamilton Pleasure Scale(SHAPS),Hamilton Depression Scale(HAMD)and Beck Scale for Suicide Ideation(BSI),respectively.If both items 4 and 5 of BSI were 0,it indicated non-suicidal ideation,the subjects were divided into a group of suicidal ideation(n=66)and a group non-suicidal ideation(n=40).Spearman correlation analysis and multivariate binary logistic regression analysis were used for a-nalysis.Results:The correlation between the scores of SHAPS and HAMD was not statistically significant(P>0.05).The SHAPS scores were positively correlated with the BSI scores(r=0.70,P<0.01).Meanwhile,binary logistic regression analysis showed that anhedonia was one of a risk factor for suicidal ideation(OR=2.34,95%CI:1.58-3.47,P<0.001).Conclusion:It suggests that anhedonia maybe partially independent of other depres-sive symptoms and it is one of the risk factors for suicidal ideation in first-episode untreated patients with depressive disorder.

关 键 词：抑郁障碍 快感缺失 自杀意念 

分 类 号：R749.41[医药卫生—神经病学与精神病学] C913.9[医药卫生—临床医学]