伴精神病性症状的双相障碍患者自杀未遂的危险因素分析

Risk factor analysis of suicide attempts in bipolar disorder patients with psychotic symptoms

目的:探讨伴有精神病性症状的双相障碍(BD)患者自杀未遂的危险因素。方法:对2010~2011年"中国BD患者诊断评估服务"项目的数据进行二次分析;对306例BD患者中伴有精神病性症状的99例(32.4%)患者应用简明国际神经精神访谈(MINI)中自杀模块分为自杀未遂组和对照组,比较两组的人口学及临床资料,Logistic回归分析伴有精神病性症状的BD患者自杀未遂的危险因素。结果:分别有36例(36.5%)及63例患者入自杀未遂组和对照组;自杀未遂组年龄明显高于对照组(t=-2.37,P=0.020);发作频繁(χ~2=8.526)、伴有不典型特征(χ~2=6.673)、有自杀观念(χ~2=6.314)、有季节性特征(χ~2=4.956)及有精神障碍家族史(χ~2=6.189)比率明显高于对照组(P<0.05或P<0.01)。Logistic回归分析显示,年龄及自杀观念与伴有精神病性症状BD患者的自杀未遂相关(OR=1.055,P=0.008,95%CI:1.014~1.098;OR=4.467,P=0.002,95%CI:1.750~11.403)。结论:年龄大及有自杀观念是伴有精神病性症状BD患者自杀未遂的主要危险因素。

Objective： To explore the risk factor of suicide attempts in bipolar disorder（BD） patients with psychotic symptoms. Method： This was a secondary analysis of the data from the diagnostic assessment service for people with BD in China（DASP）. There were 99（32. 4%） cases among the 306 BD patients diagnosed with psychotic symptoms. They were divided into the suicide attempts group and the control group according to the results of suicide module in mini international neuro-psychiatric interview（MINI）. The data of the two groups were compared,and the risk factors of suicide attempts in BD patients with psychotic symptoms were anaysed by multiple Logistic regression. Results： There were respectively 36（36. 5%） and 63 cases into the suicide attempts group and the control group. Compared to the control group,the age in the suicide attempts group was significantly elder（t =-2. 37,P = 0. 020）; the ratios of frequent attacks（χ~2= 8. 526）,accompanied by atypical features（χ~2= 6. 673）,suicidal ideation（χ~2= 6. 314）,seasonal characteristic（χ~2= 4. 956）and had family history of mental disorders（χ~2= 6. 189） were significantly higher（P 〈0. 05 or P 〈0. 01）. Logistic regression analysis showed that the age（OR = 1. 055,P = 0. 008,95% CI： 1. 014-1. 098） and depressive episodes with suicidal ideation（OR = 4. 467,P = 0. 002,95% CI： 1. 750-11. 403） were significantly associated with suicide attempts in BD patients with psychotic symptoms. Conclusion： The major risk factors for suicide attempts in BD patients with psychotic symptoms are older and suicidal idea.