童年创伤、自尊、冲动/攻击性与双相障碍躁狂首发患者症状严重程度及自杀风险的相关性

Correlation between childhood trauma,self-esteem,impulsivity/aggression and the severity of symptoms and suicide risk in patients with bipolar mania

目的 以相关分析的方式评估双相障碍躁狂首发患者童年创伤、自尊、冲动性/攻击性与症状严重程度及自杀风险的关系。方法 选取2020年6月—2022年12月于绍兴市第七人民医院就诊的双相障碍躁狂首发患者104例,按照躁狂严重程度以及自杀倾向分组,分别比较患者童年创伤问卷评分(CTQ)、自尊评分(SES)、冲动性(BIS-11)及攻击性(AQ-CV)评分情况;并分别分析上述指标与躁狂症状和自杀风险的相关性。结果 躁狂严重程度分组组间各指标比较差异均有统计学意义(均P<0.05);自杀倾向严重程度分组组间童年创伤、冲动和攻击性指标比较差异有统计学意义(均P<0.05)。相关分析显示,BRMS躁狂评分与CTQ问卷总分、情感忽视、情感虐待和性虐待维度评分相关系数分别为0.935、0.819、0.828和0.837;自杀行为问卷评分与BIS-11量表总分、认知冲动性、运动冲动性和无计划冲动性维度评分相关性分别为0.936、0.871、0.897和0.846;BRMS躁狂评分与攻击问卷总分呈高度相关(r=0.845),各维度评分r值也均超过0.8。结论 童年创伤会促进双相障碍首发躁狂患者的躁狂程度,该群体具有高攻击性,且其中冲动性可提高自杀倾向,应在治疗和干预中加以关注。

Objective To evaluate the relationship between childhood trauma,self-esteem,impulsivity/aggression and symptom severity and suicide risk in patients with bipolar mania by correlation analysis.Methods A total of 104 firstepisode manic patients with bipolar disorder in Shaoxing Seventh People's Hospital from June 2020 to December 2022 were selected and grouped according to the severity of mania and suicidal tendency.The scores of childhood trauma questionnaire(CTQ),self-esteem score(SES),impulsivity(BIS-11)and aggression(AQ-CV)were compared between groups.The correlation between the above indicators and manic symptoms and suicide risk was analyzed respectively.Results There were statistically significant differences in each index between the manic severity groups(all P<0.05).There were significant differences in childhood trauma,impulsivity and aggression between the groups of suicidal tendency severity(all P<0.05).Correlation analysis showed that the correlation coefficients between BRMS mania score and CTQ total score,emotional neglect,emotional abuse and sexual abuse were 0.935,0.819,0.828 and 0.837,respectively.The correlation between suicidal behavior questionnaire score and BIS-1l total score,cognitive impulsivity,motor impulsivity and unplanned impulsivity dimension scores were 0.936,0.871,0.897 and 0.846,respectively.The BRMS mania score was highly correlated with the total score of the aggression questionnaire(r=0.845),and the scores of each dimension were also more than O.8.Conclusion Childhood trauma can promote the degree of mania in patients with bipolar disorder.This group is highly aggressive,and impulsiveness can increase suicidal tendency,which should be paid attention to in treatment and intervention.