抑郁发作患者自杀意念与认知融合和经验性回避的关系  

Relationship between Suicidal Ideation and Cognitive Fusion and Experiential Avoidance in Patients with Depressive Episodes

作　　者：缪楹 徐晓津[1] 徐艳芩 房茂胜[1] MIAO Ying;XU Xiaojin;XU Yanqin;FANG Maosheng(Department of Wuhan Mental Health Center,Wuhan Hospital for Psychotherapy,Wuhan 430012,China)

机构地区：[1]武汉市精神卫生中心、武汉市心理医院,武汉430012

出　　处：《神经损伤与功能重建》2024年第9期501-504,517,共5页Neural Injury and Functional Reconstruction

基　　金：武汉市卫生健康委员会科研项目(接纳承诺疗法改善抑郁症心理灵活性及其影响因素的研究,No.WX20C33)。

摘　　要：目的:探究抑郁发作患者自杀意念与认知融合和经验性回避之间的关系。方法:采用随机抽样的方法纳入160例抑郁发作患者,使用一般人口学问卷、贝克自杀意念量表中文版、认知融合问卷(中文版)、接纳与行动问卷第二版(中文版)进行调查,分析自杀意念与认知融合和经验性回避的关系。结果:有无自杀意念的抑郁发作患者在受教育年限、职业、婚姻、受虐待史、认知融合、经验性回避的差异有统计学意义(均P<0.05)。自杀意念强度与认知融合(OR=0.287,P<0.05)和经验性回避(OR=0.349,P<0.05)呈正相关。在认知融合方面,“中等到强烈”的“被动尝试自杀的愿望”与“无”和“弱”的差异有统计学意义(P<0.05);在经验性回避方面,“中等到强烈”的“主动尝试自杀的愿望”和“被动尝试自杀的愿望”与“无”和“弱”的差异有统计学意义(P<0.05)。二元Logistics回归显示,受教育年限越短,自杀意念发生率越高(OR=0.781,95%CI 0.661~0.922,P=0.004),经验性回避越高,自杀意念发生率越高(OR=1.150,95%CI 1.055~1.255,P=0.002)。结论:认知融合和经验性回避均与抑郁发作患者的自杀意念强度呈正相关,经验性回避是抑郁发作患者自杀意念的风险因素。Objective:To explore the relationship between suicidal ideation and cognitive fusion and experiential avoidance in patients with depressive episodes.Methods:A total of 160 patients with depressive episode were enrolled by random sampling method.The general demographic questionnaire,Beck Suicidal Ideation Scale-Chinese version(BSI-CV),Cognitive Fusion Questionnaire(CFQ),Acceptance and Action Questionnaire-second version(AAQ-II)were used to investigate the relationship between suicidal ideation and cognitive fusion and empirical avoidance.Results:There were significant differences in years of education,occupation,marriage,history of abuse,cognitive fusion and experiential avoidance between patients with and without suicidal ideation(P<0.05).The intensity of suicidal ideation was positively correlated with cognitive fusion(OR=0.287,P<0.05)and experiential avoidance(OR=0.349,P<0.05).For cognitive fusion,the"moderate to strong""desire to passively attempt suicide"was statistically significantly different from"none"and"weak"(P<0.05).For experiential avoidance,the"moderate to strong""desire to actively attempt suicide"and"desire to passively attempt suicide"were statistically significantly different from"none"and"weak"(P<0.05).Binary Logistics regression showed that the shorter the years of education,the higher the incidence of suicidal ideation(OR=0.781,95%CI 0.661~0.922,P=0.004);the higher the experiential avoidance,the higher the incidence of suicidal ideation(OR=1.150,95%CI 1.055~1.255,P=0.002).Conclusion:Both cognitive fusion and experiential avoidance are positively correlated with the intensity of suicidal ideation in patients with depressive episode,and experiential avoidance is a risk factor for suicidal ideation in patients with depressive episode.

关 键 词：自杀意念 认知融合 经验性回避 抑郁发作 

分 类 号：R741[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]