青少年抑郁症患者非自杀性自伤的相关因素

Studies on the Related Factors of Non-suicidal Self-injury in Adolescent Patients with Depression

目的探讨青少年抑郁症患者出现非自杀性自伤的影响因素。方法选取130例在昆明医科大学第二附属医院精神科门诊就诊的首发青少年抑郁症患者,分为伴非自杀性自伤行为组(n=80)和不伴非自杀性自伤行为组(n=50)。采用中文版儿童抑郁量表(CDI)、儿童焦虑和相关障碍筛查量表、中国青少年心理韧性量表、青少年生活事件量表来进行心理因素的调查评估,采用IITC电子Von Frey测痛仪器进行皮肤压痛阈值的测试。采用Logistic回归分析青少年抑郁症患者出现非自杀性自伤行为的影响因素,绘制受试者工作特征曲线(ROC),评估各危险因素对青少年抑郁症患者发生非自杀性自伤行为的预测价值。结果不伴非自杀性自伤行为组心理韧性量表总分高于伴非自杀性自伤行为组,CDI总分、皮肤压痛阈值均低于伴非自杀性自伤行为组(P均<0.05)。多因素二元Logistic回归分析结果显示,皮肤压痛阈值、CDI总分是青少年抑郁症患者出现非自杀性自伤行为的独立危险因素。以皮肤压痛阈值、CDI总分判别青少年抑郁症患者出现非自杀性自伤行为的AUC分别为0.724、0.618,两者联合检测后,对应的AUC为0.767。结论皮肤压痛阈值、CDI总分是青少年抑郁症患者出现非自杀性自伤行为的独立危险因素。

Objective To explore the influencing factors of non-suicidal self-injury(NSSI) in adolescent patients with major depressive disorder.Methods 130 adolescent patients with the first-episode depression in the Psychiatry Department of the Second Affiliated Hospital of Kunming Medical University were divided into two groups:NSSI group(n = 80) and non-NSSI group(n = 50).The Chinese version of Children’s Depression Inventory,Children’s Anxiety and Related Disorders Screening Scale,Chinese Adolescent Psychological Resilience Scale and Adolescent Life Events Scale were used to investigate and evaluate the psychological factors.The pressure pain threshold was measured by IITC electronic Von Frey pain measuring instrument.Logistic regression was used to analyze the influencing factors of NSSI in adolescents with depression,and receiver operating characteristic curve(ROC) was drawn to evaluate the predictive value of risk factors for NSSI in adolescents with depression.Results The total score of Psychological Resilience Scale in adolescents without NSSI was higher than that in the group with NSSI,and the total score of CDI and pressure pain threshold were lower than those in the group with NSSI(P < 0.05).Pressure pain threshold values and the total CDI score were independent risk factors for NSSI behavior in adolescents with depression.According to the pressure pain threshold and the total score of CDI,the AUC of non-suicidal self-injury behavior in adolescent patients with depression was 0.724 and 0.618,respectively.After the combined detection,the corresponding AUC was 0.767.Conclusion Skin pressure pain threshold and CDI total score are the independent risk factors for NSSI behavior in adolescent patients with depression.