伴非自杀性自伤行为的青少年心境障碍患者 自杀未遂发生现状及影响因素分析
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首都卫生发展科研专项项目(2020-2-1171);北京市属医院科研培育计划项目(PX2021070、 PX2020073)


Status and influencing factors of attempted suicide in adolescent mood disorder patients with nonsuicidal self-injury
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    摘要:

    目的 探讨伴非自杀性自伤行为(NSSI)的青少年心境障碍患者合并自杀未遂(SA)及其 与临床特征的关系。方法 选取于2020 年12 月至2021 年8 月在首都医科大学附属北京安定医院住院 的有NSSI 史的80 例13~19 岁青少年心境障碍患者进行横断面调查。采用自编一般资料问卷、青少年 NSSI 问卷、简易应对方式问卷、中文版正性与负性情绪量表、儿童期创伤问卷(CTQ)进行评估。根据 近一年是否存在SA 将患者分为NSSI 组(n=33)和NSSI+SA 组(n=47)并进行组间比较。将单因素分析中 差异有统计学意义的变量纳入多因素Logistic 回归模型进行分析。结果 单因素分析显示,NSSI+SA 组≤ 16 岁、女性、复发、首发年龄< 14 岁、自伤频次≥ 40 次的患者的比例高于NSSI 组,CTQ 的情感虐 待分问卷得分高于NSSI 组,差异均有统计学意义(均P < 0.05)。NSSI 组用拳头打硬物的患者比例高于 NSSI+SA组,用刀片等割伤的患者比例低于NSSI+SA 组,差异有统计学意义(P < 0.05)。多因素Logistic 回归模型显示,年龄≤ 16 岁、用刀片等割伤的方式、自伤频次≥ 40 次、复发是NSSI+SA 同时发生的影响 因素(P < 0.05)。结论 伴NSSI青少年心境障碍患者合并SA 的发生率较高,较低的年龄、采用刀片等 割伤方式自伤、高自伤频次、复发患者更容易出现SA。

    Abstract:

    Objective To explore the relationship between suicidal attempt( SA) and clinical characteristics in adolescent patients with mood disorders with non-suicidal self injury( NSSI) behavior. Methods A total of 80 adolescent mood disorder patients aged 13-19 years were enrolled from inpatient unit of Beijing Anding Hospital from December 2020 to August 2021. Those patients with a history of NSSI were included in this analysis for a cross-sectional investigation. The self-designed general information questionnaire, adolescent NSSI behavior questionnaire, Simple Coping Style Questionnaire( SCSQ), Chinese version of Positive and Negative Affect Schedule( PANAS) and Childhood Trauma Questionnaire( CTQ) were used in the evaluation. According to presence or absence of a history of SA in the last year, the patients were divided into two groups: the NSSI group( n=33) and the NSSI+SA group( n=47). The variables with statistical significance in univariate analysis were incorporated into the multivariate Logistic regression model for analysis. Results Univariate analysis showed that the proportion of patients under 16 years old( including 16 years old), female, relapse patients, first episode age under 14 years old, NSSI frequency over 40 times( including 40 times) in NSSI+SA group was higher than that in NSSI group, and the score of emotional abuse was higher than that in NSSI group, the differences were statistically significant( P<0.05). The proportion of patients who hit hard objects with fists in NSSI group was higher than that in NSSI + SA group, and the proportion of patients who cut with blades was lower than that in NSSI+SA group( P < 0.05). Multivariate Logistic regression model showed that younger age( ≤16 years old), the method of knife cutting, high frequency of NSSI( ≥40 times), and recurrence were significant influencing factors for the co-occurrence of NSSI+SA. Conclusions The incidence of SA in adolescent mood disorder patients with NSSI is high, and SA more likely to occur in patients with lower age, self-injury by cutting, high frequency of self-injury and recurrence.

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王丹,奚蕊,王威,周佳.伴非自杀性自伤行为的青少年心境障碍患者 自杀未遂发生现状及影响因素分析[J].神经疾病与精神卫生,2022,22(4):
DOI :10.3969/j. issn.1009-6574.2022.04.011.

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  • 在线发布日期: 2022-04-25