有无自杀意念的女性复发性抑郁症临床特征比较

Comparisons of clinical features of female recurrent major depression patients with and without suicidal ideation

目的对有无自杀意念的女性复发性抑郁症患者临床特征进行比较。方法收集女性复发性抑郁症患者301例，根据是否存在自杀意念分为自杀意念组和无自杀意念组；对两组患者的人口学资料、临床特征、精神病理学、艾森克神经质量表、生活应激事件量表等进行比较。结果301例女性复发性抑郁症患者中有自杀意念者200例（66．4％）。与无自杀意念组相比，自杀意念组患者存在更多的抑郁症总症状数[（8．58±0．77）个，OR=2．476，P=1．154±10^-9]及生物学症状数[（6．74±1．07）个，OR=1．546，P=0．001]，在食欲减退（OR=2．201，P=0．011）、体质量减轻（OR=2．030，P=0．004）、早醒（OR=1．774，P=0．045）、自卑感（OR=2．352，P=0．014）、犹豫不决（OR=2．044，P=0．018）、绝望感（OR=7．130，P：6．651×10^-9）、无助感（OR=2．046，P=0．049）等方面更为常见，神经质得分更高（OR=1．631，P=0．024），遭遇了更多的生活压力事件（OR=1．302，P：0．008），差异具有统计学意义。回归分析结果显示，抑郁症总症状数（OR=4．840,P=2．685×10^-8）、生活压力事件（OR=1．392，P=0．014）、绝望感（OR=3．528，P=0．008）与自杀意念相关。结论有自杀意念的女性复发性抑郁症患者有一定的临床特征，绝望感、生活压力事件是女性复发性抑郁症患者自杀意念的危险因素，应加强对其进行临床评估。

Objective To explore the clinical features of female recurrent major depression（MD） patients with and without suicidal ideation. Methods 301 female recurrent major depression patients were interviewed by specially trained interviewers using computer evaluation system and divided into suicidal ideation group and non- suicidal ideation group according to suicidal ideation. The comparisons between the two groups were investigated on items of demographic, clinical data, assessment of psychopathology, Eysenck neurotieism questionnaire, stressful life events. Results 66.4% of MD patients have suicidal ideation. Compared with non-suicidal ideation group, there were more total number of MD symptoms （ 8.58 ± 0.77, OR = 2.476, P= 1.154 ×10^-9 ） and melancholia symptoms （6.74±1.07, OR= 1.546, P=0.001） and it was more common in the factors of less appetite （ OR=2.201, P= 0.011 ）, lose weight （ OR= 2.030, P= 0.004）, early morning awakening （ OR= 1.774, P= 0.045）, worthless （ OR = 2.352, P= 0.014） ,impaired decision-making （ OR= 2.044, P= 0.018 ）, hopelessness （ OR= 7.130, P= 6.651×10^-9） ,helpless （ OR=2.046, P=0.049） in suicidal ideation group. Also in suicidal ideation group the scores of neurotieism dimension （ OR= 1.631, P= 0.024） were higher, and they were more suffered from stressful life events （ OR= 1.302, P= 0.008）. Binary logistic regression analysis indicated that total number of MD symptoms （ OR= 4.840, P= 1.154×10^-8） ,stressful life events （ OR= 1.392, P=0.014） and hopelessness （ OR=3.528, P=0.008） were significantly associated with suicidal ideation. Conclusion Specific clinical features are associated with sui- cidal ideation among female patients of recurrent depression disorder. Hopelessness, stressful life events are risk factors of suicide ideation in female recurrent major depression patients. Integrated clinical assessment should be taken for recurrent major depression patients with suicidal ideation.