双相障碍患者儿童期虐待经历与自杀意念的关系及相关因素  

Relationship and related factors between child abuse and suicidal ideation in patients with bipolar disorder

作　　者：马若云 钟丽霞 李珠琳 谢姣 朱彩红[3] 林小玲 MA Ruoyun;ZHONG Lixia;LI Zhulin;XIE Jiao;ZHU Caihong;LIN Xiaoling(School of Nursing,Sun Yat-sen University,Guangzhou 510089,China;Department of Affective Disorder,the Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510620,China;Department of Psychiatry,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学护理学院,广州510089 [2]广州医科大学附属脑科医院情感障碍科,广州510620 [3]中山大学附属第三医院精神心理科,广州510630

出　　处：《中国心理卫生杂志》2024年第7期559-566,共8页Chinese Mental Health Journal

基　　金：广州市自然科学基金(202201011450);国家自然科学基金(71904213)。

摘　　要：目的:探讨双相障碍患者儿童期虐待、自尊、抑郁和自杀意念间的相关性,及自尊和抑郁在儿童期虐待和自杀意念间的中介作用。方法:选取符合美国精神障碍诊断与统计手册第5版(DSM-5)的292例双相障碍门诊患者,采用儿童期创伤问卷(CTQ)、Beck自杀意念量表(BSICV)、自尊量表(SES)、汉密顿抑郁量表-17项(HAMD-17)和杨氏躁狂量表(YMRS)分别评估儿童期虐待、自杀意念、自尊、抑郁及躁狂症状,采用SPSS PROCESS程序检验中介作用。结果:BSICV得分与CTQ、HAMD-17得分呈正相关(r=0.37、0.53,均P<0.010),与SES得分呈负相关(r=-0.50,P<0.010);SES得分和HAMD-17得分分别在CTQ和BSICV得分间起中介作用(95%CI:0.01~0.09、0.01~0.10)和链式中介作用(95%CI:0.02~0.06)。结论:儿童期虐待、低自尊、高抑郁水平可能是双相障碍患者自杀意念的相关因素。Objective:To explore the association between child abuse and suicidal ideation in patients with bipolar disorder.The mediation of self-esteem and depression in this association was also investigated.Methods:A total of 292 patients with bipolar disorder who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were enrolled.Their child abuse,suicidal ideation,self-esteem,depression,and mania were assessed with the Childhood Trauma Questionnaire(CTQ),Beck Scale for Suicide Ideation-Chinese Version(BSICV),Self-Esteem Scale(SES),17-item Hamilton Depression Rating Scale(HAMD-17)and Young Mania Rating Scale(YMRS).The mediating effects were evaluated using PROCESS for SPSS.Results:The BSICV scores were positively associated with the scores of CTQ(r=0.37,P<0.01)and HAMD-17(r=0.53,P<0.01)and negatively associated with SES scores(r=-0.50,P<0.01)in patients with bipolar disorder.Selfesteem and depression played mediating roles between child abuse and suicidal ideation,respectively(95%CI:0.01-0.09,0.01-0.10).Besides,self-esteem and depression sequentially mediated the relationship between child abuse and suicidal ideation(95%CI:0.02-0.06).Conclusion:Child abuse,low self-esteem,and depression may be related factors of suicidal ideation in patients with bipolar disorder.

关 键 词：自杀意念 儿童期虐待 自尊 抑郁 双相障碍 

分 类 号：C913.9[经济管理] R749.4[社会学]