童年创伤对双相障碍自杀风险的影响因素研究  

Study on the factors influencing the risk of suicide in bipolar disorder due to childhood trauma

作　　者：陈莹[1,2] 王晓婷 黄炜婷 周峥嵘 纪家武 Chen Ying;Wang Xiaoting;Huang Weiting;Zhou Zhengrong;Ji Jiawu(Departmeng of Psychiatry,Fuzhou Neuropsychiatric Hospital of Fujian Province,Neuropsychiatric Hospital Affiliated to Fujian Medical University,Fuzhou 350000,China;Now Works at Fujian Obstetrics and Gynecology Hospital)

机构地区：[1]福建省福州神经精神病防治院精神科、福建医科大学附属神经精神病医院,福州350000 [2]福建省妇产医院

出　　处：《中华精神科杂志》2024年第12期828-835,共8页Chinese Journal of Psychiatry

摘　　要：目的探讨心理弹性、领悟社会支持在双相障碍(bipolar disorder, BD)患者童年创伤与自杀风险关系中可能存在的链式中介作用, 为BD患者自杀的干预及预防在心理、家庭及社会支持上提供新的思路。方法对2023年3—9月在福建省福州神经精神病防治院住院治疗且符合ICD-10 BD诊断标准的116例患者, 进行自杀风险评估量表、童年创伤问卷、领悟社会支持量表、心理弹性量表评估;根据自杀风险评估量表得分将患者分为高、低自杀风险组。使用SPSS 26.0对数据进行统计分析, 采用χ^(2)检验、t检验或Mann-WhitneyU检验, 比较2组的人口学特征、临床特征、量表评分间的差异;使用Hayes开发的SPSS的扩展Process建立中介模型, 分析心理弹性、领悟社会支持在童年创伤和自杀风险间的中介效应。结果 (1)与低自杀风险组相比, 高自杀风险组的BD患者未婚状态比例较高(χ^(2)=6.42, P=0.039), 处于抑郁相的个体比例较高(χ^(2)=24.69, P<0.001), 发病年龄较小(Z=-2.06, P=0.036)。(2)与低自杀风险组相比, 高自杀风险的BD患者童年创伤总分、不同创伤类型(情感忽视、躯体忽视、情感虐待、躯体虐待)的得分较高, 领悟社会支持(家庭支持、朋友支持、其他支持)、心理弹性(坚韧性、力量性、乐观性)得分较低(均P<0.05)。(3)自杀风险得分与童年创伤得分、领悟社会支持得分、心理弹性得分相关性有统计学意义(r=0.49、-0.44、-0.52, 均P<0.05), 童年创伤得分与领悟社会支持得分、心理弹性得分相关性有统计学意义(r=-0.57、-0.52, 均P<0.05), 领悟社会支持得分与心理弹性得分相关性有统计学意义(r=0.70, P<0.05)。(4)心理弹性、领悟社会支持在BD患者童年创伤和自杀风险之间起链式中介作用, 中介模型的效应区间不包含0, 中介效应量为38.94%。结论心理弹性和领悟社会支持在BD患者童年创伤和自杀风险的关系中起链式中介作Objective:This study aimed to explore the potential chain mediating role of psychological resilience and perceived social support in the relationship between childhood trauma and suicide risk in patients with bipolar disorder(BD).This study aimed to provide new insights for the intervention and prevention of suicide in BD patients focusing on psychosocial,familial,and social support.Methods:From March 2023 to September 2023,a total of 116 patients who were hospitalized and met the ICD-10 diagnostic criteria for BD at the Fuzhou Neuropsychiatric Hospital of Fujian province were assessed using Suicide Risk Assessment Scale,Childhood Trauma Questionnaire,Perceived Social Support Scale,and Psychological Resilience Scale.SPSS 26.0 was used for statistical analysis.Patients were divided into high and low suicide risk groups based on their scores from the Suicide Risk Assessment Scale.Statistical analysis was performed using SPSS 26.0,employingχ^(2) tests,t-tests,or Mann-Whitney U tests to compare demographic characteristics,clinical features,and scale scores between the two groups.A mediation model was constructed using Hayes′Process extension for SPSS to analyze the mediating effects of psychological resilience and perceived social support on the relationship between childhood trauma and suicide risk.Results:(1)Compared with the low suicide risk group,BD patients with high suicide risk had a higher proportion of unmarried status(χ^(2)=6.42,P=0.039),a higher proportion of depressed individuals(χ^(2)=24.69,P<0.001),and a earlier onset age(Z=-2.06,P=0.036).(2)Compared with the low suicide risk group,BD patients with high suicide risk had higher scores for childhood trauma,different trauma type(emotional neglect,physical neglect,emotional abuse,and physical abuse),but lower scores for perceived social support(family support,friend support,other support),and psychological resilience(toughness,strength,optimism)(all P<0.05).(3)Suicide risk scores of BD patients were significantly correlated with the scores of childhood

关 键 词：双相情感障碍 自杀风险 童年创伤 领悟社会支持 心理弹性 

分 类 号：R749.4[医药卫生—神经病学与精神病学]