主要情绪障碍中的自杀风险和保护因素:一项针对4307名参与者的前性队列研究
Alessandro Miola1, Leonardo Tondo2, Marco Pinna3
1International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America; Department of Neuroscience, University of Padova, Padua, Italy.
Journal of affective disorders
|June 10, 2023
概括
双相情绪障碍 (BD) 中的自杀行为比主要抑郁障碍 (MDD) 更常见. 识别BD诊断和早期发病年龄等危险因素可以改善自杀预防策略.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 流行病学 流行病学
背景情况:
- 自杀行为是主要情绪障碍的一个重要问题.
- 量化和比较双相情感障碍 (BD) 和主要抑郁障碍 (MDD) 的风险和保护因素对于有针对性的干预至关重要.
研究的目的:
- 为了比较与被诊断患有BD和MDD的患者自杀行为相关的风险和保护因素.
- 确定主要情绪障碍中自杀行为的独立预测因素.
主要方法:
- 评估了4307名患有BD或MDD的参与者的队列.
- 在平均8.24年的随访期间,对具有和没有自杀行为的参与者的特征进行了比较.
- 用多变量后勤回归来确定独立的风险和保护因素.
主要成果:
- 11.4%的参与者发生了自杀行为,其中6.92%是致命的.
- 关键的风险因素包括BD诊断,躁狂/精神病特征,家庭自杀/BD病史,分居/离婚,早期虐待,发病年龄较小,药物滥用,以及较高的易怒/循环性/性气质.
- 保护性因素包括婚姻,同时出现的焦虑症,高血压气和抑郁的第一个发作.
- 自杀行为的独立预测因素是BD诊断,抑郁症持续时间较长,发病年龄较小,功能状况较低和BD中的女性性别.
结论:
- 自杀行为,包括暴力和致命行为,在BD中比MDD更为普遍.
- 几种风险和保护因素在BD和MDD之间存在差异,突出了对诊断特定方法的需求.
- 对这些因素的临床认知可以提高主要情绪障碍中自杀的预测和预防.
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