抑郁症患者自杀未遂的危险因素分析

Risk factors to suicidal attempt in major depressive disorder patients

目的 探讨抑郁症患者自杀未遂的一般社会人口学及临床特征方面的危险因素.方法 2010年9月1日至2011年2月28日,将来自全国13个中心的1172例住院或门诊抑郁症患者连续入组,分为自杀未遂组（989例）和非自杀未遂组（183例）,通过logistic回归分析探讨抑郁症患者自杀未遂相关的危险因素.结果 与非自杀未遂组相比,自杀未遂组起病年龄更早[（32.70±12.20）岁比（35.02±12.54）岁,P=0.021]、既往住院次数更多[（0.66±1.33）次比（0.39±0.97）次,P=0.011]、发作更频繁（13.1％比6.6％,P=0.002）、更常伴有不典型特征（23.0％比13.9％,P=0.002）及自杀观念（79.2％比52.3％,P=0.000）.logistic回归分析显示,起病年龄（OR=0.99）、既往住院次数（OR=1.17）、发作频繁（OR=2.07）、伴有自杀观念（OR=3.45）与抑郁症患者发生自杀末遂相关（均P＜0.05）.结论 起病年龄早、既往住院次数多、频繁发作及伴有自杀观念可能是抑郁症患者自杀未遂的独立危险因素.

Objective To explore the risk factors of socio-demographic and clinical characteristics related to suicidal attempt in major depressive disorder patients.Methods A total of 1172 major depressive disorder patients were consecutively examined in 13 mental health centers in China from September 1,2010 to February 28,2011.The patients＇ socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure.DSM-Ⅳ diagnoses were established using the Mini International Neuropsychiatric Interview （MINI）,and suicidal attempters （n =989） and nonattempters（n =183） were classified by the suicidality module of MINI.Multiple logistic regression were used to assess associated variables and suicidal attempt in major depressive disorder patients.Results Compared to the nonattempters,the attempters had earlier age at onset （32.70 ± 12.20 vs.35.02 ± 12.54,P =0.021）,more frequent depressive episodes （13.1％ vs.6.6％,P =0.002）,more frequent admissions （0.66 ± 1.33 vs.0.39 ±0.97,P =0.01 1）,more untypical characteristics （e.g.,increased appetite,weight gain and greater time spent sleeping） （23.0％ vs.13.9％,P =0.002）,more suicidal ideation （79.2％ vs.52.3％,P =0.000）.Logistic regression analysis showed that age at onset （OR =0.99）,number of admissions （OR =1.17）,frequent depressive episodes （OR =2.07）,depressive episodes with suicidal ideation （OR =3.45） were significant associated with suicidal attempt in major depressive disorder patients （P ＜ 0.05）.Conclusions It indicates that earlier age at onset,more frequent depressive episodes,more frequent admissions,severer suicidal ideation may be potential independent risk factors to suicidal attempt in major depressive disorder patients.