综合医院住院病人人格障碍、抑郁、焦虑与自杀意念的相关性

Correlations between personality disorders,depression,anxiety and suicidal ideation of inpatients in general hospitals

[目的]探讨综合医院非精神卫生科住院病人人格障碍、抑郁和焦虑与自杀意念之间的关系。[方法]采用Beck自杀意念量表中文版、人格障碍诊断问卷、9项病人健康问卷、7项广泛性焦虑障碍量表对1322例综合医院非精神卫生科住院病人进行调查。[结果]综合医院非精神卫生科住院病人自杀意念报告率为10.82%,有无疾病合并症的病人自杀意念报告率比较差异有统计学意义(P<0.05)。自杀意念与边缘型人格障碍、强迫型人格障碍、抑郁型人格障碍、抑郁、焦虑均呈正相关(P<0.05)。结构方程模型分析显示,构建模型拟合效果理想;人格障碍、抑郁、最严重时自杀意念直接影响最近1周自杀意念(直接效应值分别为0.13,0.25,0.60);人格障碍、抑郁、焦虑间接影响最近1周自杀意念(间接效应值分别为0.35,0.19,0.21);人格障碍、抑郁直接影响最严重时自杀意念(直接效应值分别为0.29,0.32);人格障碍、焦虑间接影响最严重时自杀意念(间接效应值分别为0.12,0.15)。[结论]综合医院非精神卫生科住院病人的人格障碍、抑郁和焦虑情绪对自杀意念有直接或间接效应,最严重时自杀意念对最近1周自杀意念有直接效应。

Objective:To probe into the correlations between personality disorders,depression,anxiety and suicidal ideation of non⁃psychiatric inpatients in general hospitals.Methods:A survey,involving 1322 non⁃psychiatric inpatients in general hospitals,was conducted by using Beck Scale for Suicide Ideation⁃Chinese Version(BSI⁃CV),Personality Diagnostic Questionnaire⁃4+(PDQ⁃4+),Patient Health Questionnaire⁃9 items(PHQ⁃9),and Generalized Anxiety Disorder⁃7(GAD⁃7).Results:The report rate of suicidal ideation of non⁃psychiatric inpatients in general hospitals was 10.82%.There were statistically significant differences in the report rates of suicidal ideation among patients with and without disease comorbidities(P<0.05).The suicide ideation was positively correlated with borderline personality disorder,obsessive-compulsive personality disorder,depressive personality disorder,depression,and anxiety(all P<0.05).Structural equation model analysis showed that the modified model fitted well.And personality disorders,depression and suicide ideation at its worst point in the patient's life(SI⁃W)had direct effects on current suicide ideation(SI⁃C).The three values of direct effect were 0.13,0.25 and 0.60,in sequence.In addition,personality disorders,depression and anxiety had indirect effects on SI⁃C.The values of indirect effect were 0.35,0.19 and 0.21,in sequence.Personality disorders and depression could have direct effects on SI⁃W.The values of direct effect were 0.29 and 0.32,respectively.Personality disorders and anxiety had indirect effects on SI⁃W.The values of indirect effect were 0.12 and 0.15,respectively.Conclusions:Personality disorders,depression,and anxiety had direct or indirect effects on suicidal ideation of non⁃psychiatric inpatients in general hospitals.And the SI⁃W could have direct effect on the SI⁃C.