急性期老年期抑郁障碍住院患者自杀风险的相关因素分析  

Related factors of suicide risk in hospitalized late life depression at acute phase

作　　者：甄文凤[1,2] 杨婧[1,2] 汪晓 马向林[1,2] 张庆娥[1,2] Zhen Wenfeng;Yang Jing;Wang Xiao;Ma Xianglin;Zhang Qing'e(Beijing Key Laboratory of Mental Disorders,National Clinical Research Center for Mental Disorders&National Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安定医院、国家精神疾病医学中心、国家精神心理疾病临床医学研究中心、精神疾病诊断与治疗北京市重点实验室,100088 [2]首都医科大学人脑保护高精尖创新中心,北京100069

出　　处：《神经疾病与精神卫生》2024年第12期837-843,共7页Journal of Neuroscience and Mental Health

基　　金：北京市教育委员会科技发展计划一般项目(KM202010025011)。

摘　　要：目的比较急性期不同自杀风险老年期抑郁障碍(LLD)住院患者的临床特征,并探究其自杀风险相关因素。方法回顾性分析2021年7月—2022年12月在首都医科大学附属北京安定医院就诊的伴有自杀风险的118例急性期LLD住院患者为研究对象,其中伴有自杀观念65例(自杀观念组)、伴有自杀未遂行为53例(自杀未遂组)。比较两组患者的一般资料、汉密尔顿焦虑量表(HAMA)得分、24项汉密尔顿抑郁量表(HAMD-24)得分。比较患者的血清促肾上腺皮质激素(ACTH)、皮质醇、血清总甲状腺素(TT4)、血清三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)及总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、雌二醇及睾酮等水平。采用二项Logistic回归分析LLD住院患者自杀未遂的相关因素。结果自杀未遂组的FT3水平低于自杀观念组,TSH水平、HAMD-24总分、认知障碍因子得分、绝望感因子得分、HAMA中精神性焦虑因子得分均高于自杀观念组,差异均有统计学意义(均P<0.05)。二项Logistic回归分析结果显示,FT3(OR=0.410,P=0.019)、精神性焦虑因子得分(OR=1.192,P=0.029)是LLD住院患者自杀未遂的相关风险因素。结论与LLD自杀观念患者相比,住院LLD有自杀未遂患者甲状腺功能水平偏低、抑郁症状较重;FT3水平、精神性焦虑因子得分是LLD住院患者自杀未遂的相关因素。Objective To compare the clinical characteristics of hospitalized patients with late life depression(LLD)at different suicide risks in the acute phase,and explore the related factors of suicide risks.Methods A retrospective analysis was conducted on 118 patients with LLD at risk of suicide,admitted to Beijing Anding Hospital,Capital Medical University during acute phase from July 2021 to December 2022,including 65 with suicidal ideation(suicidal ideation group)and 53 with attempted suicide behaviour(attempted suicide group).The general clinical data,and the scores of Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale-24(HAMD-24)were compared.The following pathology results among patients in different groups were compared,including adrenocorticotropic hormone(ACTH),cortisol,serum total thyroxine(TT4),triiodothyronine(T3),free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),estradiol,testosterone,etc.The related factors of attempted suicide in hospitalized LLD patients were analyzed by binomial logistic regression.Results Compared with the suicide ideation group,the FT3 level was lower in the attempted suicide group.Compared with the suicide ideation Objective To compare the clinical characteristics of hospitalized patients with late life depression(LLD)at different suicide risks in the acute phase,and explore the related factors of suicide risks.Methods A retrospective analysis was conducted on 118 patients with LLD at risk of suicide,admitted to Beijing Anding Hospital,Capital Medical University during acute phase from July 2021 to December 2022,including 65 with suicidal ideation(suicidal ideation group)and 53 with attempted suicide behaviour(attempted suicide group).The general clinical data,and the scores of Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale-24(HAMD-24)were compared.The following pathology results amo

关 键 词：老年期抑郁障碍 住院 自杀风险 临床特征 风险因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]