慢性阻塞性肺疾病患者伴发自杀观念的发生率及相关危险因素分析

Analysis of the incidence and related risk factors of suicidal ideation in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者的自杀观念发生率及其相关危险因素。方法选取2017年1月~2018年6月广州市越秀区中医医院的200例COPD患者进行调查,采用自制的调查问卷收集患者的基本社会人口学资料和临床资料。应用17项汉密尔顿抑郁量表(HAMD-17)评定患者的抑郁症状,7项广泛焦虑障碍量表(GAD-7)评定患者的焦虑症状,12项简版健康相关生存质量量表(SF-12)评定患者的生活质量。结果COPD患者的自杀观念发生率为24.5%(49/200)。自杀观念组患者(n=49)的独居比例高于非自杀观念组(n=151),年龄、GAD-7总分、HAMD-17总分均高于非自杀观念组,差异有统计学意义(P<0.05)。自杀观念组与非自杀观念组患者的SF-12精神、躯体症状评分比较,差异有统计学意义(P<0.05)。回归分析结果提示,独居(β=1.393;OR=7.670;95%CI=1.14~14.2;P<0.05)、抑郁症状(β=0.069;OR=1.071;95%CI=1.02~1.12;P<0.05)和焦虑症状(β=0.302;OR=1.360;95%CI=1.20~1.52;P<0.05)是自杀观念的独立危险因素。结论COPD患者存在自杀观念现象较为常见,独居、抑郁和焦虑症状是自杀观念COPD患者的独立危险因素,临床需要引起重视。

Objective To investigate the incidence of suicidal ideation and related risk factors in patients with chronic obstructive pulmonary disease (COPD).Methods From January 2017 to June 2018,200 patients with COPD from Yuexiu District Hospital of Traditional Chinese Medicine in Guangzhou City were selected for investigation.Basic social demographic and clinical data of patients were collected by self-made questionnaires.The depression symptoms of the patients were assessed by the 17-item Hamilton depression scale (HAMD-17),the anxiety symptoms were assessed by the 7-item generalized anxiety disorder scale (GAD-7),and the quality of life was assessed by the 12-item health related quality of life scale (SF-12).Results The incidence of suicidal ideation in COPD patients was 24.5%(49/200).The proportion of patients living alone in the suicidal ideation group (n=49) was higher than that in the non-suicidal ideation group (n=151),and the age,GAD-7 total score and HAMD-17 total score were all higher than those in the non-suicidal ideation group,with statistically significant differences (P<0.05).The SF-12 scores of mental and somatic symptoms in the suicidal ideation group and the non-suicidal ideation group showed statistically significant differences (P<0.05).Regression analysis results suggested that living alone (β=1.393;OR=7.670;95%CI=1.14-14.2;P<0.05),depressive symptoms (β=0.069;OR=1.071;95%CI=1.02-1.12;P<0.05) and anxiety symptoms (β=0.302;OR=1.360;95%CI=1.20-1.52;P<0.05) were the independent risk factors for suicidal ideation.Conclusion The phenomenon of suicide ideation is common in COPD patients.Living alone,depression and anxiety are independent risk factors for COPD patients with suicide ideation,which need to be paid attention to clinically.