重性抑郁障碍患者认知功能对自杀意念的影响

The influence of cognition on suicidal ideation of major depressive patients

目的分析重性抑郁障碍患者认知功能对自杀意念的影响。方法选取2017年1月至2018年9月在北京回龙观医院的住院重性抑郁障碍患者108例,根据自杀意念自评量表(self-rating idea of suicide scale,SIOSS)评分,分为有自杀意念组(n=48)和无自杀意念组(n=60)。采用自制一般情况调查表收集被试一般资料,采用重复成套神经心理状态测量(repeatable battery for the assessment of neuropsychological status,RBANS)评定认知功能。采用Logistic回归对各相关因素进行分析。结果(1)经评定有自杀意念者为48例,重性抑郁障碍患者自杀意念发生率44.4%。(2)有自杀意念组[RBANS总分(63.0±7.9)分;RBANS即刻记忆(62.7±8.8)分;RBANS视觉广度(67.2±10.0)分;RBANS言语功能(83.3±13.8)分;RBANS注意(85.3±11.9)分;RBANS延时记忆(53.5±7.7)分]和无自杀意念组[RBANS总分(73.8±7.7)分;RBANS即刻记忆(70.8±7.6)分;RBANS视觉广度(72.7±9.8)分;RBANS言语功能(91.5±4.5)分;RBANS注意(99.9±8.5)分;RBANS延时记忆(62.3±9.7)分]RBANS总分及各因子分的差异均有统计学意义(F=6.335~46.660,P<0.05),有自杀意念组均比无自杀意念组评分低。(3)Logistic回归结果显示,受教育年限是自杀意念的危险因素(β=0.289,P=0.013,OR=1.335,95%CI=1.063~1.676),RBANS注意因子(β=-0.161,P=0.000,OR=0.851,95%CI=0.778~0.931)、RBANS延时记忆因子(β=-0.151,P=0.006,OR=0.860,95%CI=0.772~0.957)是自杀意念的保护因素。结论认知功能对抑郁患者的自杀意念有影响,注意和延时记忆是自杀意念的保护因素。

Objective To analyze the influence of cognition on suicidal ideation in patients with major depressive disorder. Methods A total of 108 inpatients with major depressive disorder from January 2017 to September 2018 in Beijing Huilongguan Hospital were enrolled.They were divided into suicidal ideation group (n=42) and non-suicidal ideation group (n=66) by the self-rating idea of suicide scale (SIOSS). Cognition was assessed by Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). The general situation was assessed by self-made general situation questionnaire.The related factors were analyzed by Logistic regression. Results (1) The rate of suicidal ideation was 44.4% in patients with major depressive disorder.(2) The total score of RBANS and five-factor scores of RBANS in suicidal ideation group were lower than those in non-suicidal ideation group(total RBANS score(63.0±7.9) vs (73.8±7.7);immediate memory:(62.7±8.8) vs (70.8±7.6);visual span:(67.2±10.0) vs (72.7±9.8);speech function:(83.3±13.8) vs (91.5±4.5);attention:(85.3±11.9) vs (99.9±8.5);delayed memory:(53.5±7.7) vs (62.3±9.7), F=6.335-46.660, P<0.05).(3)Logistic regression showed, years of education were risk factors for suicidal ideation(β=0.289, P=0.013, OR=1.335, 95%CI=1.063-1.676), RBANS attention factor(β=-0.161, P=0.000, OR=0.851, 95%CI=0.778-0.931)and RBANS delayed memory factor score(β=-0.151, P=0.006, OR=0.860, 95%CI=0.772-0.957)were protective factors for suicidal ideation. Conclusion Cognitive function has an impact on suicide ideation of depressive patients, mainly attention and delayed memory are protective factors for suicide ideation.