不同性别双相情感障碍患者发生自杀行为的临床特征比较研究

目的:研究双相情感障碍患者自杀行为相关因素的性别差异。方法:依据ICD-10诊断标准入组有自杀行为的双相情感障碍患者1739例和无自杀行为的双相情感障碍患者3713例,进行不同性别间各项目的比较分析,通过Logistic回归分析男、女性双相情感障碍患者自杀行为相关的危险因素。结果:男、女性伴自杀行为双相情感障碍患者在年龄、婚姻状况、职业、吸烟史、饮酒史、重大精神创伤史、入院次数等方面差异有统计学意义(P<0.05)。男性伴自杀行为患者较无自杀行为者年龄更大、已婚者更多、独生子女较少、较多家族自杀史、家族精神异常史、既往自杀史,差异有统计学意义(P<0.01)。女性伴自杀行为者较无自杀行为者年龄更大、较多饮酒史、重大精神创伤史、家族自杀史、既往自杀史,差异有统计学意义(P<0.05)。Logistic回归分析显示,女性患者的重大精神创伤、家族自杀史、既往自杀史与发生自杀行为相关(P<0.05)。男性患者的既往有自杀史与发生自杀行为相关(P<0.01)。结论:男、女性双相情感障碍患者的自杀行为危险因素存在一定差异,区别化对待其危险因素对预防自杀有重要意义。

Gender Difference of Suicide Behavior and Clinical Features in Bipolar Disorders

Objective:To analyze the gender difference of the factors related to suicidal behavior in bipolar dis orders.Methods:1739 bipolar disorders with suicidal behavior and 3713 bipolar disorders without suicidal behavior consistent with ICD-10 diagnostic criteria were selected.Socio-demographic and clinical features were collected to investigate gender-related differences.Multiple logistic regression model was used to assess gender difference of risk factors in bipolar disorders with suicidal behavior.Results:Male and female patients with suicidal behaviors showed significant differences in age,suicidal behavior,marital status,impulsive personality,only-child,and number of hospitalizations,history of smoking and drinking,history of mental trauma and psychoactive substance depilatory (P＜0.05).Male patients with suicidal behavior,compared to those without suicidal behavior,significantly had older age,less rate of only-child,higher marriage rate,more history of suicide,more family history of suicide and mental illness (P＜0.01).Compared to those without suicidal behavior,female patients with suicidal behavior significantly had younger age,higher alcohol consumption rate,more history of mental trauma,more history of suicide and more family history of suicide (P＜0.05).In a backward logistic regression model,history of mental trauma,history of suicide and family history of suicide were significantly correlated with female patients with suicidal behavior (P＜0.05) and history of suicide was significantly associated with male patients with suicidal behavior (P＜0.05).Conclusion:It indicates that there are differences in risk factors related to suicidal behavior between male and female bipolar disorders.It is important to prevent suicide by distinguishing the risk factors between male and female bipolar disorder.