伴自杀未遂的儿童青少年抑郁症患者的家庭功能特点

Study on characteristics of family function in children and adolescents with major depressive disorder and suicide attempt

目的探索伴自杀未遂的儿童青少年抑郁症患者的家庭功能特点。方法2019年1月至2020年1月招募来自四川大学华西医院门诊、住院部11~18岁的66例儿童青少年抑郁症伴自杀未遂的患者(抑郁症伴自杀未遂组)及75例儿童青少年抑郁症不伴自杀未遂的患者(抑郁症不伴自杀未遂组),通过张贴广告至社会及学校招募70名健康儿童青少年(健康对照组)。采用贝克抑郁量表对病例组进行抑郁严重程度评分;使用家庭一般情况调查表、家庭功能评定量表(FAD)对3组对象的家庭一般情况及家庭功能的七个维度进行调查并进行组间比较。采用多元有序Logistic回归方法对儿童青少年抑郁症伴自杀未遂的影响因素进行分析。结果儿童青少年抑郁症伴自杀未遂组与抑郁症不伴自杀未遂组贝克抑郁量表得分差异无统计学意义[35.00(28.00,42.00)比34.0(27.00,41.00),Z=1.310,P=0.190]。与健康对照组比较,儿童青少年抑郁症伴自杀未遂组情感反应因子[18.00(15.00,19.50)分比15.00(13.00,17.00),Z=-4.741,P<0.01]、沟通因子[25.00(22.50,28.00)分比21.00(19.00,23.00)分,Z=-5.310,P<0.01]、角色因子[31.00(28.00,34.00)分28.00(26.00,30.00)分,Z=-4.434,P<0.01]、情感介入因子[16.00(14.00,19.00)分比13.00(12.00,15.00)分,Z=-4.426,P<0.01]、行为控制因子[22.00(20.00,23.00)分比20.00(18.00,22.00)分,Z=-3.451,P=0.002]、问题解决因子[15.00(12.00,17.00)分比13.00(12.00,14.50)分,Z=-3.404,P=0.002]、总体功能[32.00(27.00,35.00)分比25.00(23.00,28.00),Z=-5.337,P<0.001]。情感反应评分高(OR=1.150,95%CI:1.036~1.278,P=0.009)、家庭不和睦(OR=5.912,95%CI:2.319~15.090,P<0.01)、健康状况很差(OR=6.360,95%CI:1.964~20.594,P=0.002)、母亲本科及以上学历(OR=5.392,95%CI:1.539~18.900,P=0.008)是儿童青少年抑郁症自杀未遂的相关因素。结论抑郁伴自杀未遂的儿童青少年抑郁症患者家庭功能较差,且家庭功能差是儿童青少年抑郁症出现自杀未遂行为的相关因素。

Objective To explore the characteristics of family function in children and adolescents with major depressive disorde(r MDD)and suicide attemp(t SA).Methods From January 2019 to January 2020,66 children and adolescents aged from 11 to 18 years with MDD and SA were recruited from the outpatient department and inpatient department of West China Hospital of Sichuan University(MDD with SA group)and 75 children and adolescents with MDD without SA(MDD without SA group).70 healthy children were recruited from the society and schools by posting advertisements(healthy control group).The severity of depression was assessed by Beck Depression Inventory.Family general condition scale and Family Assessment Device(FAD)scale were used to investigate general family function and the seven dimensions of family function.Multiple logistic regression was used to analyze the influencing factors of children and adolescents with MDD and SA.Results There was no significant difference in the score of Beck Depression Inventory between MDD with SA group and MDD without SA group[35.00(28.00,42.00)vs 34.0(27.00,41.00),Z=1.310,P=0.190].Compared with the healthy control group,the results of MDD with SA group were as follows:the emotional response factor[18.00(15.00,19.50)vs 15.00(13.00,17.00),Z=-4.741,P<0.01],communication factor[25.00(22.50,28.00)vs 21.00(19.00,23.00),Z=-5.310,P<0.01],role factor[31.00(28.00,34.00)vs 28.00(26.00),Z=-4.434,P<0.01],emotional intervention factors[16.00(14.00,19.00)vs 13.00(12.00,15.00)score,Z=-4.426,P<0.01],behavior control factor[22.00(20.00,23.00)vs 20.00(18.00,22.00),Z=-3.451,P=0.002],problem solving factor[15.00(12.00,17.00)vs 13.00(12.00,14.50),Z=-3.404,P<0.01],general function factor[32.00(27.00,35.00)vs 25.00(23.00,28.00),Z=-5.337,P<0.01].High affective responsiveness score(OR=1.150,95%CI=1.036-1.278,P=0.009),family disharmony(OR=5.912,95%CI=2.319-15.090,P<0.01),poor health status(OR=6.360,95%CI=1.964-20.594,P=0.002)and mother's education background(Bachelor degree or above)(OR=5.392,95%CI=1.539-18.900,P=0.008)were the related factors of SA in children and adolescents with MDD.Conclusions Children and adolescents with MDD and SA often have poor family function,which is related to MDD and SA.