边缘型人格障碍患者自杀意念特征及危险因素分析

Suicidal ideation and its risk factors in borderline personality disorder

目的探讨边缘型人格障碍患者自杀意念特征及其危险因素，提高对边缘型人格障碍自杀风险的认识。方法选取门诊和住院的边缘型人格障碍（borderline personality disorder，BPD）患者共84例为病例组（n=84），并按1：1配比选择性别和年龄（±2岁）与病例组频数匹配健康对照组（n=84）。采用Barratt冲动性量表、Buss—Perry攻击量表、儿童期虐待问卷、Beck抑郁量表、Beck绝望量表、Beck自杀意念量表对两组被试施测。结果（1）病例组自杀意念发生数84例，最近一周自杀意念总分[（4．94±4．57）分，（0．50±0．51）分]，最严重时自杀意念总分[（20．43±6．58）分，（1．26±2．60）分]，自杀意念总分[（25．37±9．78）分，（1．76±3．65）分]，均显著高于对照组（t=8．499，24．972，20．847，P〈0．01）。（2）多元线性回归分析显示BPD患者自杀意念的影响因素7个：行动冲动性、儿童期躯体忽视、冲动性、共病轴Ⅰ诊断、儿童期躯体虐待、无业、非已婚（β=0．876，0．640，0．428，0．350，0．236，0．165，-0．205，均P〈0．05）。结论边缘型人格障碍患者的自杀意念多而强烈，需对其自杀意念危险因素有足够认识，从而降低自杀风险。

Objective To investigate suicidal ideation and its risk factors in patients with borderline personality disorder （ BPD）, and raise awareness of suicidal risk in BPD. Methods Patients with BPD were selected from in-patient and out-patient departments as case group（ n= 84） ,while 84 subjects were selected as control group, 1 ： 1 matched by gender and age. Barratt impulsiveness scale, Buss-Perry aggression ques- tionnaire, childhood trauma questionnaire, Beck depression inventory, Beck hopelessness scale and Beck scale for suicide ideation were used to measure the two groups. Results （ 1 ） In case group, the number of incidence of suicidal occurred was 84 .The scores of suicidal ideation in the recent week（4.94±4.57 vs 0.50± 0.51 ）, suicidal ideation in the worst situation（ 20.43±6.58 vs 1.26±2.60） and the total score（ 25.37±9.78 vs 1.76±3.65） were statistically higher than those in control group （ t= 8.499,24.972,20.847, all P〈0.O1 ）. （ 2 ） Multiple regression analysis showed that motor impulsivity, physical neglect in childhood, impulsivity, co- morbidity of axis I disorders, physical abuse in childhood, unemployment and unmarried status were risk factors of suicidal ideation in patients with BPD （β= 0.876,0.640,0.428,0.350,0.236,0.165, -0.205, all P〈 0.05）. Conclusion The suicide ideation of patients with BPD are prevalent and intense. Awareness of risk factors for patients with BPD, thereby reducing the risk of suicide.