伴焦虑症状抑郁症患者自杀未遂的危险因素

Abstract

目的：分析伴焦虑症状抑郁症患者自杀未遂的人口学资料及临床特征方面的危险因素。方法来自全国13个中心的728例伴有焦虑症状抑郁症患者，根据简明国际神经精神访谈（mini international neuropsy?chiatric interview，MINI）5.0中文版自杀模块，评估其是否有自杀未遂行为。采用多因素logistic回归，分析伴焦虑症状抑郁症患者在性别、年龄、民族等人口学资料及伴精神病性症状、伴不典型特征等临床特征方面可能与自杀未遂相关的危险因素。结果伴焦虑症状抑郁症患者中，135例（18.5%）有自杀未遂，593例（81.5%）无自杀未遂。有自杀未遂组与无自杀未遂组相比，起病年龄早[（32.3±11.9）vs.（35.3±13.1）]，既往抑郁发作次数多（中位数：2 vs.2），既往住院次数多（中位数：1 vs.0），更多患者出现抑郁发作频繁（14.8%vs.7.4%），更常伴不典型症状（25.9%vs.15.0%）和伴自杀意念（78.5%vs.50.3%），应用抗抑郁剂治疗者更多见（81.5%vs.71.2%），差异均具有统计学意义（P<0.05）。Logistic回归分析显示，伴焦虑症状抑郁症患者既往住院次数多（OR=1.18，95%CI：1.02~1.37）、抑郁发作频繁（OR=2.05，95%CI：1.14~3.68）、伴自杀意念（OR=3.55，95%CI：2.28~5.54）与自杀未遂相关联（P<0.05）。结论既往住院次数多、抑郁发作频繁、伴自杀意念可能是伴焦虑症状抑郁症患者自杀未遂的危险因素。

Objective To analyze the risk factors of socio-demographic and clinical characteristics related to sui?cidal attempt in major depressive disorder (MDD) patients with anxious characteristics. Methods Based on the anxious module of Mini International Neuropsychiatric Interview (MINI), a total of 728 anxious MDD patients from 13 major men?tal health centers in China were classified as suicidal and non-suicidal attempt groups. Further analyses regarding risk factors of suicidal attempt in anxious MDD patients were performed by the multivariate logistic regression analysis. Re?sults Among the 728 patients with anxious MDD analyzed, 135 (18.5%) of them had suicidal attempt and 593 (81.5%) had non-suicidal attempt. Compared to the non-suicidal attempt group, patients with suicidal attempt had significantly earlier age onset[(32.3 ± 11.9) vs. (35.3 ± 13.1)], more lifetime depression episodes (median:2 vs. 2), more number of ad?missions (median: 1 vs. 0), more frequent depressive episodes (14.8% vs. 7.4%), more atypical characteristics (25.9%vs.15.0%), more suicidal ideation (78.5%vs. 50.3%) and more antidepressant use (81.5%vs. 71.2%). Logistic regression analysis showed that number of admissions (OR=1.18, 95%CI:1.02~1.37), frequent depressive episodes (OR=2.10, 95%CI:1.14~3.68), depressive episodes with suicidal ideation (OR=3.55, 95%CI:2.28~5.54) were associated with suicidal at?tempt in MDD patients with anxious characteristics (P<0.05). Conclusions More number of admissions, more frequent depressive episodes, comorbid suicidal ideation may be risk factors of suicidal attempt in anxious MDD patients.