抑郁障碍患者自杀未遂的危险因素分析

目的:分析抑郁障碍(MDD)患者自杀未遂的危险因素。方法:入组332例MDD患者,分为自杀未遂组(95例)和非自杀未遂组(237例);对入组者进行人口学与临床资料调查、汉密尔顿抑郁量表(HAMD-24)及汉密尔顿焦虑量表(HAMA-14)评估及血清甲状腺功能检测,并进行组间比较;分析自杀未遂的危险因素。结果:自杀未遂组年龄、首次发病年龄明显小于非自杀未遂组,病程、既往住院次数明显多于非自杀未遂组;单身、无业、受教育程度低、家族史阳性、伴有精神病性症状、共病焦虑障碍比率明显高于非自杀未遂组(P<0.05或P<0.01)。HAMD总分与焦虑躯体化、认知障碍、阻滞、绝望感、体质量、日夜变化因子分及HAMA评分明显高于非自杀未遂组(P<0.05或P<0.01)。血清游离三碘甲状腺原氨酸(FT3)水平明显高于非自杀未遂组(P<0.05)。多因素Logistic回归分析显示,伴有精神病性症状、既往住院次数、HAMD评分中认知障碍、绝望感因子是影响抑郁症患者自杀未遂的主要危险因素。结论:伴有精神病性症状、既往住院次数、HAMD评分中的认知障碍、绝望感因子可能为MDD患者...

Risk factors of suicide attempt in patients with major depressive disorder

Objective:To explore the risk factors of attempted suicide in patients with major depressive disorder(MDD).Method:332 MDD patients were investigated and divided into attempted suicide group(n=95)and non-attempted suicide group(n=237).Demographic and clinical data were investigated.The participants were assessed by Hamilton Depression Scale(HAMD-24)and Hamilton Anxiety Scale(HAMA-14),and serum thyroid function were detected.Risk factors for attempted suicide was analyzed.Results:The age and first onset age of the attempted suicide group were significantly lower than those of the non-attempted suicide group,and course of the disease and the number of previous hospitalizations were significantly higher than those of the non-attempted suicide group.The ratio of single,unemployed,low education level,positive family history,accompanied by psychotic symptoms,comorbid anxiety disorder were significantly higher than those of the non-attempted suicide group(P<0.05 or P<0.01).The total score of HAMD and its factor scores including somatization of anxiety,cognitive disorder,block,sense of despair,body mass,day and night change,as well as the HAMA score were significantly higher than those of the non-attempted suicide group(P<0.05 or P<0.01).The serum free triiodothyrosine(FT3)level was significantly higher than that of the non-attempted suicide group(P<0.05).Multivariate Logistic regression analysis showed that psychotic symptoms,hospitalization times,cognitive impairment and sense of despair in HAMD score were the main risk factors for suicide attempt in the MDD patients.Conclusion:Psychiatric symptoms,the number of previous hospitalization,cognitive impairment and sense of despair factor in HAMD score may be the risk factors for suicide attempt in MDD patients.