抑郁症新兵自杀风险因素的临床研究

A clinical study of risk factors for suicide in recruits with depression

目的了解抑郁症新兵自杀和自杀风险度的基本情况及其影响因素。方法收集2019和2020年在中国人民解放军第九八七医院进行精神类疾病鉴定为抑郁症的102名男性新兵,根据汉密尔顿抑郁量表17项(Hamilton depression scale,17-item,HAMD17)的条目3得分将抑郁症新兵分为抑郁症无风险组和抑郁症自杀风险组;抑郁症自杀风险组根据对自身伤害的风险程度分为单纯自杀意念组、自伤行为组和自杀行为组。采用人口学调查、艾森克人格问卷、症状学自评量表及脑功能分析仪检测脑内神经递质水平,对新兵自杀和自杀风险度的影响因素进行分析。结果抑郁症无风险组、抑郁症自杀风险组、单纯自杀意念组、自伤行为组、自杀行为组的症状自评量表得分分别为(265.07±81.62)、(309.26±82.91)、(295.70±93.93)、(305.56±62.42)和(351.63±67.17)分。抑郁症无风险组和抑郁症自杀风险组在失眠方面差异有统计学意义(t=288.00,P<0.05);神经质(OR=1.05,95%CI=1.00~1.09)、偏执(OR=4.74,95%CI=2.06~10.91)和谷氨酸(OR=1.24,95%CI=1.04~1.49)是抑郁症新兵出现自杀风险的影响因素;神经质、精神病性因子和去甲肾上腺素水平与抑郁症的自杀风险严重程度均呈正相关(r=0.41、0.25、0.34,均P<0.05);精神病性因子(OR=9.13,95%CI=1.26~3.16)是自杀风险严重程度的独立影响因素。结论失眠、神经质、偏执因子和谷氨酸水平是抑郁症新兵自杀的影响因素;神经质、精神病性因子和去甲肾上腺素水平与抑郁症自杀风险度有关,其中精神病性因子是自杀风险度的独立影响因素。

Objective To explore the Basic information and influencing factors of suicide and suicide risk in depressed recruits.Methods A total of 102 male recruits who were identified as depression in the No.987 Hospital of the PLA in 2019 and 2020 were collected,and divided into the depression risk free group and depression suicide risk group according to item 3 score of the Hamilton depression scale,17-item,(HAMD17).According to the risk of self-harm,the depression suicide risk group was divided into simple suicidal ideation group,self-injury behavior group and suicidal behavior group.The demography survey,Eysenck personality questionnaire,symptomatic self-rating scale and brain function analyzer were used to detect the levels of neurotransmitters in the brain,and the influencing factors of suicide and suicide risk in recruits were analyzed.Results The symptomatic self-rating scale scores of depression risk free group,depression suicide risk group,simple suicidal ideation group,self-injury behavior group and suicidal behavior group were(265.07±81.62),(309.26±82.91),(295.70±93.93),(305.56±62.42)and(351.63±67.17)points,respectively.There was statistically significant difference in insomnia between depression risk free group and depression suicide risk group(t=288.00,P<0.05).Neuroticism(OR=1.05,95%CI=1.00-1.09),paranoia(OR=4.74,95%CI=2.06-10.91)and glutamate(OR=1.24,95%CI=1.04-1.49)were the influencing factors of suicide risk in depressed recruits.Neuroticism,psychotic factor,and norepinephrine level(r=0.41,0.25,0.34,all P<0.05)were all positive associated with the severity of suicide risk in depression.Psychiatric factor(OR=9.13,95%CI=1.26-3.16)was the independent influencing factor of the severity of suicide risk.Conclusion Insomnia,neuroticism,paranoid factor and glutamate level are the influencing factors for suicide in depression recruits,while neuroticism,psychotic factor and norepinephrine level are related to the suicide risk degree of depression,among which psychotic factor is the independent influencing factor of suicide risk degree.