负性生活事件及心理弹性对青少年抑郁症患者自杀行为的影响
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河北省省级科技计划资助项目(21377711D);河北省引进国外智力项目(YZ202306);河北省医学科学研究课题计划(20240536);河北省医学科学研究课题(20201141)


Impact of negative life events and psychological resilience on suicide behavior in adolescents with depressive disorder
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    摘要:

    目的 探讨负性生活事件及心理弹性对青少年抑郁症患者自杀行为的影响。方法 采用 方便抽样法,选取 2021 年 4 月— 2023 年 6 月于河北医科大学第一医院精神卫生中心住院或门诊就诊的 217 例青少年抑郁症患者为研究对象,根据简明国际神经精神访谈(MINI)既往有无自杀未遂史,分为 自杀未遂组(n=49)及非自杀未遂组(n=168)。采用汉密尔顿抑郁量表(HAMD)、童年期创伤问卷(CTQ-SF)、青少年生活事件量表(ASLEC)、心理弹性量表(CD-RISC)评估患者的抑郁程度、童年期创伤经历、 生活事件和心理弹性。采用单因素分析和二项 Logistic 回归分析青少年抑郁症自杀行为的相关影响因 素。结果 217 例青少年抑郁症患者中,自杀行为的发生率为 22.58%(49/217)。单因素分析结果显示, 两组患者的首发年龄、学校欺凌、非自伤性自杀、自杀意念、HAMD 评分、CTQ 总分、情感虐待得分、人 际关系得分、心理弹性总分、坚韧性得分、乐观性得分比较,差异均有统计学意义(均P< 0.05)。 二项 Logistic 回归分析结果显示,存在学校欺凌(OR=2.473,95%CI=1.036~5.902)、存在自杀意念(OR=10.206, 95%CI=1.909~54.557)、情感虐待得分高(OR=1.213,95%CI=1.076~1.368)、人际关系得分高(OR=1.139, 95%CI=1.041~1.246)是青少年抑郁症患者自杀行为的危险因素(P< 0.05),而乐观性得分高(OR=0.845, 95%CI=0.719~0.993)是保护因素(P<0.05)。结论 青少年抑郁症患者自杀行为发生率较高,学校欺凌、 自杀意念、情感虐待、人际关系不佳是自杀行为的危险因素,良好的心理弹性是自杀行为的保护因素。

    Abstract:

    Objective To explore the impact of negative life events and psychological resilience on suicide behavior in adolescents with depressive disorder. Methods From April 2021 to June 2023, convenience sampling was used to select 217 adolescents with depressive disorder at the Mental Health Center of the First Hospital of Hebei Medical University as participants. According to the MINI International Neuropsychiatric Interview (MINI), individuals with a history of attempted suicide were divided into two groups of attempted suicide group (n=49) and non-attempted suicide group (n=168). Hamilton Depression Scale (HAMD), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Adolescent Self-rating Life Events Check List (ASLEC), and Connor-Davidson Resilience Scale (CD-RISC) were used to assess the patient's depressive disorder, childhood trauma, life events, and psychological resilience, respectively. Univariate analysis and binomial Logistic regression were used to analyze the influencing factors of suicide behavior in adolescents with depressive disorder. Results Among 217 adolescents with depressive disorder, the incidence of suicide behavior was 22.58% (49/217). Univariate analysis showed that there were statistically significant differences in the age of onset, school bullying, non-suicidal self-injury, suicidal ideation, HAMD score, CTQ total score, emotional abuse score, interpersonal relationship score, psychological resilience total score, hardiness score, and optimism score between the two groups of patients (all P < 0.05). Binomial Logistic regression analysis showed that school bullying [OR=2.473, 95%CI (1.036, 5.902)], suicidal ideation [OR=10.206, 95%CI (1.909, 54.557)], high emotional abuse scores [OR=1.213, 95%CI (1.076, 1.368)], and high interpersonal relationship scores [OR=1.139, 95%CI (1.041, 1.246)]were risk factors for suicide behavior in adolescents with depressive disorder (P < 0.05), while high optimism scores [OR=0.845, 95%CI (0.719, 0.993)]were protective factors for suicide behavior, and the differences were statistically significant (P< 0.05). Conclusions The incidence of suicide behavior is higher in adolescents with depressive disorder. School bullying, suicidal ideation, emotional abuse, and poor interpersonal relationships are risk factors for suicide behavior, while good psychological resilience is a protective factor for suicide behavior.

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高媛媛,王冉,任若佳,王岚,李娜,赵天宇,卢文婷,黄凡凡,刘不凡,焦艳明,张聪敏,赵晓川,王金成,王学义.负性生活事件及心理弹性对青少年抑郁症患者自杀行为的影响[J].神经疾病与精神卫生,2024,24(9):629-634
DOI :10.3969/j. issn.1009-6574.2024.09.004.

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  • 在线发布日期: 2024-10-08