重度抑郁症患者自杀意念相关因素及干预现状调查研究

The related factors of suicidal ideation and intervention in patients with severe depression

目的探究重度抑郁症患者自杀意念相关因素,并对干预现状进行分析。方法选取2017年7月~2019年6月宁波市精神病院收治的重度抑郁症患者172例,采用自杀意念自评量表(SIOSS)评估患者有无自杀意念,并分为有自杀意念组与无自杀意念组,采用二元logistic回归模型分析影响自杀意念的相关因素,对患者实施1个月药物与认知行为干预,观察干预效果。结果172例重度抑郁症患者中有自杀意念的患者为88例(51.16%),有自杀未遂史的38例(22.09%);自杀意念组年龄、婚姻状况、兴趣或愉快感丧失、焦虑状况、无价值感或自罪感、自杀未遂史、HAMD评分、睡眠状况与无自杀意念组比较差异有统计学意义(P<0.05);二元logistic回归模型分析显示:年龄≤25岁、女性、自杀未遂史、兴趣或愉快感丧失、无价值感或自罪感影响自杀意念产生的独立危险因素(P<0.05);干预后,自杀意念组患者HAMD评分、SIOSS评分、PSQI评分、SAS评分均低于干预前,差异有统计学意义(P<0.05)。结论重度抑郁症患者自杀意念出现的可能性高,其中年龄≤25岁、女性、自杀未遂史、兴趣或愉快感丧失、无价值感或自罪感的患者应重点关注,并积极给予药物、认知行为干预,以改善病情。

Objective To discuss the related factors of suicidal ideation and current intervention in patients with severe depression.Methods 172 patients with severe depression admitted to Ningbo psychiatric hospital from July 2017 to June 2019 were selected and divided into the suicidal ideation group and the non suicidal ideation group based on the self-rating idea of suicide scale(SIOSS)evaluation result.The binary logistic regression model was used to analyze the related factors of suicidal ideation.Patients received drug treatment and cognitive behavior intervention for a month,and the clinical effects were observed.Results 88 out of 172 patients with severe depression had suicidal ideation,accounting for 51.16%,and 38 had history of attempted suicide,accounting for 22.09%.There were significant differences in age,marital status,loss of interest or pleasure,anxiety status,sense of worthlessness or self guilt,history of attempted suicide,HAMD score,sleeping status between suicidal ideation group and non suicidal ideation group(P<0.05).The binary logistic regression analysis showed that age≤25 years old,female,history of attempted suicide,loss of interest or pleasure,sense of worthlessness or self guilt were the independent risk factors of suicidal ideation(P<0.05).After one month intervention,the scores of HAMD,SIOSS,PSQI and SAS in suicidal ideation group were significantly lower than those before intervention(P<0.05).Conclusions Patients with severe depression are more likely to commit suicide,especially female patients and those with age≤25 years old,having history of attempted suicide,with loss of interest or pleasure,having sense of worthlessness or self guilt.Therefore,drug therapy as well as cognitive behavior intervention should be proposed.