| SSRI 治疗首发为抑郁发作的双相障碍患者对自杀风险的相关因素分析 |
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| 引用本文： | 李则挚,苑成梅,黄佳,洪武,胡莺燕,曹岚,卢卫红,王勇,吴志国,陈俊,方贻儒.SSRI 治疗首发为抑郁发作的双相障碍患者对自杀风险的相关因素分析[J].中国神经精神疾病杂志,2011,37(12). |
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| 作者姓名： | 李则挚 苑成梅 黄佳 洪武 胡莺燕 曹岚 卢卫红 王勇 吴志国 陈俊 方贻儒 |
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| 作者单位： | 上海交通大学附属精神卫生中心心境障碍科,上海,200030 |
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| 基金项目： | 国家自然科学基金项目(编号:30971047,81000581,81171272); 国家高科技研究发展计划(863计划)(编号:2006AA02Z430); 上海交通大学医学院“重点学科建设”:临床精神病学(编号:沪交医科【2008】-6); 上海市公共卫生优秀青年人才培养项目(编号:08GWQ075); 上海市卫生系统新优青计划(编号:XYQ2011014) |
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| 摘 要： | 目的 探讨双相障碍首次抑郁发作使用SSRI类抗抑郁剂治疗后,出现自杀风险的相关因素.方法 回顾性记录177例以抑郁发作为首次发作形式的双相抑郁障碍患者人口学资料和临床特征,并比较它们在没有出现自杀组和出现自杀组之间的差异,采用逐步Logistic回归方法进行分析,受试者工作特征曲线(ROC)与Hosmer-Lemeshow分别评估危险因素模型的准确度和拟合优度.结果 没有出现自杀风险患者154例,出现自杀风险患者23例.出现自杀风险的患者组中饮酒史、心境障碍家族史、有易激惹症状、绝望感和伴随精神病性症状的比例高于未出现自杀风险的患者组(均P<0.05).进一步回归分析显示,使用SSRI类抗抑郁剂治疗而导致自杀风险的相关因素为:易激惹(OR=4.04,95%CI:1.40-11.67,P<0.05),有精神病性症状(OR=6.23,95%CI:1.41-27.56,P<0.05).ROC为0.71.Hosmer-Lemeshow为0.58.结论 易激惹症状、精神病性症状是双相障碍首次抑郁发作予SSRI治疗出现自杀风险的潜在预测因素.
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| 关 键 词： | 双相障碍 首发抑郁发作 自杀风险 五羟色胺再摄取抑制剂 |
The factors associated with occurrence of suicidal risk after treatment of SSRI in bipolar disorder with their first depressive episode |
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| LI Zezhi,YUAN Chengmei,HUANG Jia,HONG Wu,Hu Yingyan,Cao Lan,LU Weihong,Wang Yong,WU Zhiguo,CHEN Jun,FANG Yiru.The factors associated with occurrence of suicidal risk after treatment of SSRI in bipolar disorder with their first depressive episode[J].Chinese Journal of Nervous and Mental Diseases,2011,37(12). |
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| Authors: | LI Zezhi YUAN Chengmei HUANG Jia HONG Wu Hu Yingyan Cao Lan LU Weihong Wang Yong WU Zhiguo CHEN Jun FANG Yiru |
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| Institution: | LI Zezhi,YUAN Chengmei,HUANG Jia,HONG Wu,Hu Yingyan,Cao Lan,LU Weihong,Wang Yong,WU Zhiguo,CHEN Jun,FANG Yiru.Department of Mood disorder,Shanghai Mental Health Center,School of Medicine,Shanghai Jiao tong University,Shanghai 200030,China |
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| Abstract: | Objective To explore the factors associated with occurrence of suicidal risk after treatment of selective serotonin reuptake inhibitor(SSRI) in bipolar disorder with their first depressive episode.Methods One hundred and seventy seven bipolar patients were enrolled in this retrospective study.Demographic and clinic features between non-occurrence of suicidal risk group and occurrence of suicidal risk group were compared.Stepwise Logistic regression model was used to identify the associated factors.Concordan... |
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| Keywords: | Bipolar disorder First depressive episode Suicidal risk Selective serotonin reuptake inhibitor(SSRI) |
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