未治疗抑郁障碍患者自杀风险与认知情绪调节策略的关系

Association between suicide risk and cognitive emotion regulation strategies in untreated depressive disorder patients

目的探讨具有自杀风险的抑郁障碍患者在认知情绪调节策略方面的特征及其影响因素,以早期识别具有自杀风险的患者,有针对性地给予干预。方法选取117例来自北京回龙观医院门诊、经简明国际神经精神访谈(MINI)5. 0中文版筛查符合抑郁障碍诊断标准的未治疗抑郁障碍患者,根据MINI 5. 0中文版自杀模块的访谈结果,将患者分为自杀风险组(n=52)和无自杀风险组(n=65)。采用认知情绪调节问卷(CERQ-C)进行认知调节策略的测评,采用汉密尔顿抑郁量表17项版(HAMD-17)评定抑郁症状的严重程度。结果抑郁障碍患者自杀风险发生率为44. 4%(52/117)。与无自杀风险组相比,自杀风险组患者更多见于女性、未婚、平均年龄更小、发病年龄更早、HAMD-17总评分更高、伴精神病性症状率较高,自杀风险组自我责难、接受、沉思、灾难化4个认知调节策略维度及消极认知情绪调节评分均高于无自杀风险组(P均<0. 05)。Logistic回归分析显示,女性(OR=3. 539,95%CI:1. 383~9. 057)、发病年龄(OR=0. 931,95%CI:0. 895~0. 968)、HAMD-17总评分(OR=1. 207,95%CI:1. 063~1. 370)和灾难化(OR=1. 143,95%CI:1. 002~1. 305)与抑郁障碍患者自杀风险相关(P均<0. 05)。结论女性、发病年龄早、抑郁症状严重和灾难化可能为未治疗抑郁障碍患者自杀风险的危险因素。

Objective To explore the characteristics of cognitive emotion regulation strategies and influencing factors of cognitive emotion regulation strategies among depressive disorder patients at risk of suicide,so as to provide basis for the targeted intervention at early stages.Methods A total of 117 outpatients with untreated depressive disorder from Beijing Huilongguan Hospital who met the diagnostic criteria for depression disorder in Chinese version of Mini International Neuropsychiatric Interview 5.0(MINI 5.0) were enrolled.According to the suicidality module of MINI 5.0,patients were divided into the suicide risk group(n=52) and non-suicide risk group(n=65).Them the Cognitive Emotion Regulation Questionnaire-Chinese Version(CERQ-C) and Hamilton Depression Scale-17 item(HAMD-17) were used to evaluate the cognitive emotion regulation strategy and the severity of depressive symptoms.Results The suicide risk in patients with depressive disorder was 44.4%(52/117).Compared with non-suicide risk group,patients in the suicide risk group were mostly female,unmarried,with earlier onset age,lower average age,higher HAMD-17 score,and higher complication rate of psychotic features.Moreover,the scores of self-blame,acceptance,rumination,catastrophization and negative cognitive emotion regulation strategies were also higher in suicide risk group(P<0.05).Logistic regression analysis showed that female(OR=3.539,95% CI:1.383-9.057),onset age(OR=0.931,95% CI:0.895-0.968),HAMD-17 scores(OR=1.207,95% CI:1.063-1.370) and catastrophization(OR=1.143,95% CI:1.002-1.305) were associated with suicide risk in patients with depressive disorder(P<0.05).Conclusion Female,early onset,severity of depressive symptoms and catastrophization may be the main risk factors for suicide risk in untreated patients with depressive disorder.