停止尿床年龄与青少年自杀行为的关系

Age of attaining nocturnal bladder control and adolescent suicidal behavior

目的探讨停止尿床年龄与青少年自杀行为的关系。方法对1920名11岁～16岁的青少年进行调查,由父母完成包括青少年生长发育史、自杀行为、抑郁症状、攻击行为及家庭环境等定式问卷。结果在控制一系列儿童及家庭情况变量后,多变量Logistic回归模型显示3岁后停止尿床与青少年自杀行为的危险性增加显著相关,停止尿床年龄与青少年自杀行为之间存在量效关系(3岁～4岁停止尿床OR值为2.1,5岁及以上停止尿床OR值为3.6)。中介变量分析显示,停止尿床时间晚对自杀行为的效应,至少部分通过抑郁及攻击行为中介。结论停止尿床时间晚可能是青少年自杀行为的早期神经发育预测因素,应进一步探讨青少年自杀行为的早期神经发育危险因素及潜在机制。

Objective To explore the relationship between the age of attaining nocturnal bladder control and adolescent suicidal behavior. Methods A community sample of 1920 adolescents aged 11-16 years participated in the study. Parents completed a structured questionnaire including adolescents＇ developmental history, suicidal behavior, depressive symptoms, aggressive behavior, and family environment. Results Multivariate logistic regression models indicated that attaining nocturnal bladder control after 3 years was significantly associated with increased risk for adolescent suicidal behavior, after controlling for a number of child and family covariares. A dose-response relationship between the age of attaining nocturnal bladder control and suicidal behavior was observed （OR=2.1 for children attaining bladder control at 3-4 years and OR=3.6 for children attaining bladder control at 5 years or later）. Mediating models indicated that depression and aggressive behavior mediated,at least in part,the effect of delayed nocturnal bladder control on suicidal behavior. Conclusion Delayed nocturnal bladder control may be an earlier neurodevelopmental predictor of youth suicidal behavior. Further research is suggested to explore earlier neurodevelopmental risk factors and potential mechanisms of youth suicidal behavior.