心境障碍科青年人群住院患者非自杀性自伤行为的回顾性分析

Retrospective analysis of the non-suicidal self-injury of the young hospitalized patients in the department of mood disorders

目的:调查分析精神专科医院心境障碍科青年住院患者非自杀性自伤(non-suicidal self-injury,NSSI)行为的发生情况及相关因素。方法:回顾性分析168例精神专科医院心境障碍科住院的所有14~25岁患者的病历资料,包括人口学和临床资料、自杀风险评估表、精神病患者暴力危险分级评估表。根据现病史中有无自伤行为记录,将患者分为NSSI组和非NSSI组;比较两组在性别、父母是否离异、有无家族史、童年是否受创伤、自杀风险评估量表得分、精神病患者暴力危险分级评估表得分上的差异。结果:NSSI组48例(28.6%),非NSSI组120例(71.4%);NSSI组在自杀风险评估量表(t=-3.21,P=0.002)与精神病患者暴力危险分级评估表(t=-4.07,P=0.000)得分显著高于非NSSI组(P均<0.01);暴力冲动程度及自杀风险程度进入二分类Logistic回归方程,高暴力冲动(P=0.001,OR=1.158,95%CI:1.060~1.265)、高自杀风险(P=0.007,OR=1.129,95%CI=1.033~1.234)是NSSI行为的危险因素。结论:心境障碍科青年住院患者的NSSI行为发生率较高,其危险因素为高暴力冲动性和高自杀风险。

Objective:To investigate and analyze the occurrence of non-suicidal self-injury(NSSI)of the young hospitalized patients in the department of mood disorders and its related factors.Method:The medical records of all patients aged 14-25 years(n=168)admitted to the department of mood disorders were retrospectively analyzed,including demographic and clinical data,the Nurses’global assessment of suicide risk(NGASR),and violent risk assessment form for mental patients.Patients were divided into NSSI group and non-NSSI group according to whether NSSI was recorded in the history of present disease.Descriptive statistics of demographic and clinical data were collected and analyzed.The two groups were compared on gender,whether parents were divorced,family history,childhood trauma,suicide risk assessment scale score,and violent risk rating scale score of psychiatric patients.Results:A total of 48 inpatients with NSSI behavior were included in the survey,accounting for 28.6%of the total number of patients.The score of NSSI group on NGASR(t=-3.21,P=0.002)and the violent risk assessment scale of mental patients(t=-4.07,P=0.000)were significantly higher than those of the non-NSSI group,and the differences were statistically significant.The degree of violent impulse and the degree of suicide risk were entered into the binary Logistic regression equation,where the high violent impulse(P=0.001,OR=1.158,95%CI=1.060-1.265)and the high suicide risk(P=0.007,OR=1.129,95%CI=1.033-1.234)were close risk factors for NSSI behavior.Conclusion:The incidence of NSSI behavior in hospitalized young people in the department of mood disorders is high,and the risk factors are high violent impulsivity and high risk of suicide.