有无自杀行为单相抑郁症患者父母生育年龄及胎次效应的比较

Parental age at delivery and birth order in unipolar major depressive patients with suicidal behavior versus without suicidal behavior

目的:比较有无自杀行为单相抑郁症患者间父母生育年龄及胎次效应有否差异。方法:调查标本来源于1983-06-01/2003-05-31在无锡市精神卫生中心门诊和住院诊断为抑郁症、无严重躯体疾病或脑器质性疾病及任何类型的躁狂发作的患者177例。以单相抑郁症患者为先证者,采用自行编制的精神病家系调查表(内容主要包括患者及一级亲属所有成员社会人口学资料、疾病发作特点及次数、自杀情况),由两名主治医师或以上的研究人员对每一家系进行调查。由两名研究人员在互不知情的情况下对每一患者进行再诊断。对所有先证者及一级亲属中有自杀行为者进行面检(面检率>95%);对无自杀行为的一级亲属则进行信函调查(53%)及面检(47%)。已死亡及不能进行面检者的资料由一两名一级亲属提供有关情况填写调查表。观察有自杀行为单相抑郁症患者及无自杀行为单相抑郁症患者父母育龄及胎次的效应。结果:按实际处理分析,共收集到有自杀行为的单相抑郁症患者59例无自杀行为的单相抑郁症患者56例。有自杀行为的单相抑郁症患者之一级亲属自杀危险性3.8%(14/373)较无自杀行为患者的一级亲属自杀危险性1.4%(5/363)高(χ2=4.14,P<0.05),有自杀行为单相抑郁症患者与父母生育年龄及胎次的关系非常显著(C=2.4>2,P<0.01,6A>M;

AIM:To compare the differences of parental age at delivery and birth order between the unipolar major depressive patients with and without suicidal behavior.METHODS:Totally 177 patients with depression who had been diagnosed without serious systemic diseases or organic brain syndrome and all types of mania,were selected from the outpatients or inpatients of Wuxi Mental Health Center from June 1,1983 to May 31,2003.Self drafted questionnaire by psychiatrists including such parameters as social demographic data,characters and times of episode,and suicide of patients and their first degree relatives was surveyed by two psychiatrists or more professional physicians in each family,using the patients with unipolar major depressive disorder as probands.Each of these patients was re diagnosed by two psychopathists unknown to each other.Face to face detection was performed in all the probands and their first degree relatives with suicidal behavior,and the detection rate was over 95%,but letter survey and face to face detection were used in the probands' first degree relatives without suicidal behavior in the rate of 53%and 47%respectively.One or two first degree relatives of the probands who had been dead or could not provide their data through face to face detection were asked to fill in the questionnaire about these probands' related conditions.The effects of parental age at delivery and birth order in the unipolar major depressive patients with or without suicidal behavior were observed.RESULTS:According to the actual management,59 patients suffering from unipolar major depressive disorder with suicidal behavior and 56 such patients without suicidal behavior were collected.The suicide risk in the first degree relatives of probands with suicidal behavior was 3.8%(14/373),which was higher than that in the ones without suicidal behavior(1.4%,5/363)(χ2=4.14,P< 0.05).Parental age and birth order were significantly related to suicidal behavior in unipolar major depressive patients(C=2.4 >2,P< 0.01,6A >M,6A is the product of summation of birth order sequence A from the siblings out of each family in all groups and 6,M is the expected average value of 6A).Parental age and birth order were also significantly related to suicidal behavior not in patients with unipolar major depression(C=4.45 >2,P< 0.001,but 6A< M).CONCLUSION:The older parental age at delivery and the later birth order are,the more easily suicidal behavior occurs in unipolar major depressive patients.The younger parental age at delivery and the earlier birth order are,the less easily suicidal behavior occurs in unipolar major depressive patients.The suicide risk is higher in the first degree relatives of unipolar major depressive patients with suicidal behavior than in the ones without suicidal behavior.