女性双相情感障碍住院患者高自杀风险的相关因素分析

The analysis of related factors of high suicide risk in female inpatients with bipolar disorder

目的分析女性双相情感障碍(BD)住院患者高自杀风险的相关因素。方法收集2010年4月至2019年6月首都医科大学附属北京安定医院378例女性BD住院患者的病历资料。根据患者自杀风险,分为低自杀风险组(n=220)和高自杀风险组(n=158)。比较两组患者的一般人口学资料及临床特征差异,采用二项Logistic回归分析女性BD住院患者高自杀风险的相关因素。结果与低自杀风险组相比,高自杀风险组患者的本次住院天数少、首发年龄及首次抑郁发作年龄小、总发作次数及抑郁发作次数多、躁狂发作次数少、首发症状为抑郁者和双相Ⅱ型障碍者(BD-Ⅱ)比例高、有精神病性症状者比例少,差异均有统计学意义(均P<0.05)。二项Logistic回归分析显示,抑郁发作次数(OR=1.56,95%CI=1.32~1.83)、BD类型(OR=2.30,95%CI=1.16~4.58)以及是否伴精神病性症状(OR=0.56,95%CI=0.35~0.90)是女性BD患者高自杀风险的相关因素(P<0.05)。结论抑郁发作次数频繁、BD-Ⅱ、不伴精神病性症状是影响女性BD患者高自杀风险的因素。

Objective To analyze the related factors of high suicide risk in female inpatients with bipolar disorder(BD).Methods The medical records of 378 female BD inpatients in Beijing Anding Hospital Affiliated to Capital Medical University from April 2010 to June 2019 were collected.Patients were divided into low suicide risk group(n=220)and high suicide risk group(n=158)according to their suicide risk.The differences of general demographic data and clinical characteristics between the two groups were compared.Binomial Logistic regression analysis was used to explore the related factors of high suicide risk in female BD inpatients.Results Compared with the low suicide risk group,the patients in the high suicide risk group had significantly reduced length of hospital stay,younger age of first onset and younger age of first depressive episode,increased total number of episodes and number of depressive episodes,decreased number of manic episodes,increased proportion of patients with onset symptoms of depression and bipolarⅡdisorder(BD-Ⅱ),and lower proportion of patients with psychotic symptoms,and the differences were statistically significant(all P<0.05).Binomial Logistic regression analysis showed that the number of depressive episodes(OR=1.56,95%CI=1.32-1.83),types of BD(OR=2.30,95%CI=1.16-4.58)and with or without psychotic symptoms(OR=0.56,95%CI=0.35-0.90)were related to the high suicide risk in female patients with BD(P<0.05).Conclusions The frequent depressive episodes,BD-Ⅱand without psychotic symptoms were the factors influencing the high risk of suicide in female patients with BD.