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1.
目的探讨氟西汀联合认知行为治疗(CBT)对急性期非典型特征抑郁症疗效及负性自动思维和自杀意念的影响。方法选取2019年1月—2021年6月海南省人民医院心理科诊治急性期非典型特征抑郁症患者80例,随机数字表法分为对照组和观察组,各40例。对照组采用氟西汀治疗12周,观察组采用氟西汀联合CBT治疗12周。比较2组抗抑郁治疗效果,治疗前后抑郁程度(HAMD17评分)、负性自动思维(ATQ评分)、自杀意念(BSI-CV评分)和社会功能(GAF评分)差异。结果观察组治疗总有效率高于对照组(85.00%vs.62.50%,χ2=5.230,P=0.022)。治疗后2组HAMD17评分、ATQ频繁程度评分、ATQ相信程度评分、最近1周自杀意念强度评分、最抑郁时自杀意念强度评分、最近1周自杀危险性评分、最抑郁时自杀危险性评分、最近1周BSI-CV总分、最抑郁时BSI-CV总分均较治疗前降低,GAF评分较治疗前增加,且观察组改善优于对照组(t=9.314、9.389、7.657、4.771、7.119、6.391、6.185、4.582、8.166、5.472,P均<0.001)。结论氟西汀联合CBT治疗可更有效地缓解抑郁程度,降低负性自动思维和自杀意念水平,提高社会功能。  相似文献   
2.
IntroductionNeuropsychiatric disturbance is common in individuals with Lewy body dementia (LBD). Despite this, there is minimal research regarding suicide risks in this population.MethodsThis study was a retrospective review of a prospectively-collected database at a tertiary movement disorders clinic. Database participants with an LBD diagnosis at their most recent visit and at least one complete Beck Depression Inventory-II (BDI-II) were included. Additional measures included demographics and measures of cognition, psychiatric symptoms, motor function, and the Parkinson Disease Questionnaire-39. The frequency of suicidal ideation was assessed using question 9 of the BDI-II. Features associated with a BDI-II score greater than zero were assessed using logistic regression.ResultsThe database included 95 individuals with LBD and at least one BDI-II (visit years 2010–2020). Most participants were older men who identified as white. Eighteen individuals (18.9%; 95% CI 12.3%–28.0%) reported thoughts of killing themselves without an intent to carry them out (BDI-II = 1). No participants reported a desire or plan to kill themselves. The presence of SI was associated with measures of depression, anxiety, and emotional well-being, but not with demographics, measures of disease severity, or other psychiatric concerns.ConclusionThese findings emphasize the importance of routine screening for psychiatric symptoms in LBD and intervention when such concerns are identified. Interventions could include pharmacologic (e.g. depression treatment) and non-pharmacologic (e.g. firearm screening) approaches. More research is needed to assess suicidal ideation and suicide risks in large and more diverse LBD populations. Prospective studies should include measures of additional potential contributors to suicidality.  相似文献   
3.
目的分析双相情感障碍伴自杀行为患者的流行病学特征,提高对其诊治水平。方法选取2016年5月至2018年5月洛阳市第五人民医院(太康路院区)精神科收治的186例双相情感障碍患者,年龄(43.15±5.66)岁,年龄范围为23~55岁,对患者流行病学特征进行统计,并通过logistic回归分析与各种危险因素之间的关系。结果根据有无自杀行为将患者分为有自杀行为组(n=96)和无自杀行为组(n=90),两组患者性别、婚姻状况、人际关系、是否为独生子女方面比较,差异无统计学意义(P>0.05);两组患者年龄、吸烟史、精神异常史、饮酒史方面比较,差异有统计学意义(P<0.05)。男性有自杀行为组与男性无自杀行为组患者年龄、婚姻状况、吸烟史、人际关系、是否为独生子方面比较,差异无统计学意义(P>0.05);男性有自杀行为组与男性无自杀行为组患者精神异常史、是否饮酒、家族自杀史、既往自杀史比较,差异有统计学意义(P<0.05)。女性有自杀行为组与女性无自杀行为组患者婚姻状况、人际关系、是否为独生子女方面比较,差异无统计学意义(P>0.05);女性有自杀行为组与女性无自杀行为组患者年龄、吸烟史、精神异常史、饮酒史、家族自杀史、既往自杀史方面比较,差异有统计学意义(P<0.05)。logistic回归分析显示,女性、年龄大、重大精神创伤、既往自杀史与双相情感障碍伴自杀行为均呈正相关。结论女性、年龄大、有重大精神创伤、有自杀家族史、既往自杀史等都可能是双相情感障碍伴自杀行为患者的危险因素临床上应给予高度重视并及早采取干预措施,以免延误最佳治疗时机。  相似文献   
4.
目的:观察奥氮平联合氟西汀治疗伴自杀意念抑郁症患者的效果。方法:选取80例伴自杀意念抑郁症住院患者为研究对象,采用随机数字表法分为研究组和对照组各40例。对照组采用氟西汀治疗,研究组在对照组基础上联合奥氮平治疗。比较两组的抑郁量表(HAMD-17)评分、自杀意念(BSSI量表)评分、认识功能(MoCA量表)评分、治疗效果及不良反应发生情况。结果:治疗2周、4周、8周后,两组HAMD-17评分和BSSI评分均低于治疗前,且研究组均低于对照组,差异有统计学意义(P<0.05);治疗8周后,两组MoCA总分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率为90.00%,明显高于对照组的67.50%,差异有统计学意义(P<0.05);研究组不良反应发生率为55.00%,与对照组的42.50%比较,差异无统计学意义(P>0.05)。结论:奥氮平联合氟西汀治疗伴自杀意念抑郁症患者,可降低抑郁评分和自杀意念评分,提高认识功能和治疗总有效率,效果优于单纯氟西汀治疗效果。  相似文献   
5.
6.
Abstract

Objective: This study aims at identifying associations between cognitive function and suicidal ideation in the sample of patients with anxiety and mood disorders (AMD).

Methods: In sum, 186 (age = 39?±?12.3 years; 142 [76.3%] females) patients with AMD were enrolled in the study. Assessment included evaluation of socio-demographic information, medication use, anxiety and depression symptoms. Cognitive tests included measures of psychomotor performance and incidental learning using the Digit Symbol Test. Trail Making Tests respectively measured perceptual speed, task-switching and executive control. Additionally, 21 patients completed tests from the Cambridge Automated Neuropsychological Test Battery measuring set shifting (Interdimensional/extradimensional set-shift), executive planning (Stockings of Cambridge), and decision making (Cambridge Gamble Task [CGT]).

Results: Almost half (45.0%, n?=?86) of the study sample patients had experienced suicidal ideations. In multivariable regression analysis, suicidal ideation was associated with a greater overall proportion of bet and risk taking on the CGT task (β?=?0.726, p?=?.010 and β?=?0.634, p?=?.019), when controlling for socio-demographic characteristics, medication use, anxiety and depression symptoms.

Conclusions: Outpatients with AMD and suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain, particularly in impulse-control and risk taking.  相似文献   
7.
ObjectivesAdolescent suicide is a global problem. This study aimed to identify associations between parental marital status and suicidal behavior.MethodsThis study analyzed 118 715 middle and high school students from the 13th and 14th Korea Youth Risk Behavior Web-based Survey. The odds ratios (ORs) of suicidal ideation, planning, and attempts were calculated based on parental marital status, living situation, and socioeconomic factors. The data were analyzed using multiple logistic regression.ResultsWhen compared to those living with 2 married biological parents, the ORs of suicidal ideation among adolescents living with either remarried or no parents were 1.34 (95% confidence interval [CI], 1.17 to 1.53) and 1.36 (95% CI, 1.11 to 1.66), respectively. For suicidal planning, the OR of those living with 1 remarried biological parent was 1.24 (95% CI, 1.01 to 1.52), and that of those living without parents was 1.28 (95% CI, 0.95 to 1.73), when compared to adolescents living with 2 married biological parents. For suicide attempts, when compared to adolescents with 2 married biological parents, the OR of those living with 1 remarried biological parent was 1.48 (95% CI, 1.17 to 1.87) and that of those living without parents was 2.02 (95% CI, 1.44 to 2.83). For adolescents living with 1 remarried biological parent, suicidal behavior was strongly associated with having no siblings and were weakly associated with not living with grandparents.ConclusionsSuicidal behavior among adolescents was associated with the remarriage and loss of parents. Therefore, special attention and interventions are needed for adolescents in those situations.  相似文献   
8.
《L'Encéphale》2022,48(6):632-637
ObjectivesBipolar disorder is one of the most common and severe psychiatric conditions. It is frequently complicated by suicidal behaviors, and patients with BD are among those at higher risk of suicide. The aims of our study were to evaluate the predictive factors of suicidal behaviors in patients with BD type 1, through the assessment of their socio-demographic, clinical and evolutionary characteristics as well as to study the implications of the childhood traumas and impulsivity as predictive factors for suicidal behaviors in these patients with bipolar disorder.MethodsOne hundred patients with bipolar disorder type 1were recruited in order to conduct a cross-sectional, analytical and comparative study. The recruitment involved a first group made up of 40 patients suffering from type 1 bipolar disorder with a history of suicidal acts. This group was compared with a second group made up of 60 patients with no history of attempted suicide. We used a pre-established collection sheet for collecting socio-demographic, clinical and therapeutic data. We also used the Childhood Trauma Questionnaire for the assessment of childhood adversities, the Barratt Impulsivity Scale in its eleventh version for the assessment of impulsivity levels and the Global Assessment of Functioning Scale for the evaluation of overall functioning.ResultsThe suicidal behaviors in patients with bipolar disorder were significantly associated with: female gender (P < 0.001), professional instability (P = 0.002), family history of BD (P = 0.02), family history of other psychiatric disorders (P = 0.003), frequency of depressive episodes (P = 0.002), shorter remission (P = 0.025), more subsyndromal symptoms (P = 0.029), sexual abuse dimension (P = 0.009), and a high level of impulsivity (P < 0.001). The predictive factors for suicidal behaviors in multivariate analysis, after adjusting for the confounding variables were: childhood sexual abuse (P = 0.01; adjusted OR 4.5; 95% CI 1.44–14.2), a high level of impulsivity (P = 0.002; adjusted OR 6.6; 95% CI 2–20), a higher rate of depressive episodes (P = 0.003; adjusted OR 5; 95% CI 1.69–14.2) and more subyndromal symptoms (P = 0.007; adjusted OR 5.8; 95% CI 1.63–20).ConclusionsSuicide prevention is an important mental health subject. It would be imperative to include systematic screening for childhood adversities and adequate management of bipolar disorder and impulsivity.  相似文献   
9.
10.

Objectives

Feeling ashamed for seeking help when distressed is known to be a critical factor promoting suicidal behaviors. The objective of this study was to examine the relationship between suicidal ideation and psychosocial factors, including worries or anxieties, having a person to confide in, feeling ashamed for seeking help when distressed, and K6 score.

Methods

Fourteen out of 77 municipalities from Nagano Prefecture participated in this questionnaire survey. Participants of both sexes over 20 years of age were randomly selected according to age distribution in each municipality. Association between suicidal ideation and sociodemographic and psychosocial factors, including “feeling ashamed for seeking help”, were determined by multiple logistic regression analysis.

Results

Among a total of 11,100 participants, 7394 (66.6 %) returned the questionnaire. 2147 participants responded properly to essential study parameters and were submitted to the final analyses. The adjusted odds ratio of suicidal ideation was 2.09 (95 % CI 1.49–2.94) among participants feeling ashamed for seeking help, compared to those not feeling ashamed. Although the rate of “no person to confide in” was 4.4 %, participants who responded with “no person to confide in” had significantly increased odds ratio of suicidal ideation compared with those who responded with “having a person to confide in” (OR 1.97, 95 % CI 1.12–3.47).

Conclusions

Our findings suggest a need for tailored intervention targeting individuals at risk by gatekeepers to encourage individuals at risk to overcome feeling ashamed for seeking help and to cultivate an appropriate person to confide in.
  相似文献   
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