幻听与抑郁发作患者非自杀性自伤行为的关联性研究

Relationship between Auditory Hallucinations and Non-suicidal Self-injury behaviors in Patients with Depressive Episodes

目的:探究抑郁发作患者非自杀性自伤行为(non-suicidal self-injury,NSSI)检出特征及其与幻听之间的关系。方法:采用随机整群抽样的方法纳入473例抑郁发作患者,使用一般人口学问卷、渥太华自伤量表和精神症状评定量表中文版(Psychotic Symptom Rating Scales,PSYRATS)进行调查,分析NSSI与幻听症状的关系。结果:抑郁发作患者NSSI检出率为40.6%,NSSI在年龄、性别、病程、职业、受教育程度、婚姻状况、家族史、诊断分类、吸烟史、饮酒史和有无幻听等方面差异有统计学意义(均P<0.05)。有幻听症状的男性和女性抑郁发作患者NSSI检出率分别为42.9%和67.6%,无幻听症状分别为19.8%和42.1%,差异均有统计学意义(均P<0.05)。在诊断分类上,单相抑郁发作组中有无幻听症状的NSSI检出率差异有统计学意义(P<0.05),其中男性和女性NSSI检出率差异均有统计学意义(P<0.05);在双相抑郁发作中有无幻听症状的NS-SI检出率差异有统计学意义(P<0.05),但仅在女性中NSSI检出率差异有统计学意义(P<0.05)。幻听与NSSI最常自伤部位有一定关联性(P<0.05)。幻听与NSSI行为特征值二元Logistic回归显示:在调整了性别、年龄、职业等因素后,幻听与NSSI行为呈显著正相关(OR=1.04,95%CI 1.01~1.08,P<0.05)。结论:抑郁发作患者幻听症状与NSSI行为呈正相关。

Objective:To explore the detected characteristics of non-suicidal self-injury(NSSI)behaviors and their relationship with auditory hallucination in patients with depressive episodes.Methods:A total of 473 patients with depressive episodes were enrolled by random cluster sampling.The general demographic questionnaire,the Ottawa Self-Injury Scale and the Chinese version of the Psychiatric Symptom Rating Scale(PSYRATS)were used to analyze the relationship between NSSI and auditory hallucination symptoms.Results:The detection rate of NSSI in patients with depressive episodes was 40.6%.NSSI had statistically significant differences in age,sex,course of disease,occupation,education level,marital status,family history,diagnostic classification,smoking and drinking history,and presence of auditory hallucinations(P<0.05).The prevalence of NSSI was 42.9%and 67.6%in men and women with auditory hallucinations,and 19.8%and 42.1%in men and women without auditory hallucinations;the differences were statistically significant(P<0.05).In terms of diagnostic classification,the detection rate of NSSI between patients with and without auditory hallucinations in the unipolar depressive episode group was significantly different(P<0.05),which was significant different both in males and females(P<0.05).The detection rate of NSSI between patients with and with auditory hallucination in the group of bipolar depressive episodes was significantly different(P<0.05),which was significant different only in females(P<0.05).Auditory hallucinations were associated with the most frequent sites of NSSI(P<0.05).After adjustment of for gender,age and occupation,binary Logistic regression showed that there was a significant positive correlation between auditory hallucinations and NSSI behavior characteristic values(OR=1.04,95%CI 1.01~1.08,P<0.05).Conclusion:Auditory hallucinations in patients with depressive episodes is positively correlated with NSSI behavior.