青年男性军人精神障碍者自杀未遂的危险因素分析

Analysis on risk factors of suicide attempt in young malesoldiers with mental disorders

目的 分析青年男性军人精神障碍者自杀未遂的危险因素,为军人自杀早期防控提供参考。方法 2021年6月—2022年3月,连续入组60例确诊精神障碍的青年男性军人,分为自杀未遂组(33例)和非自杀未遂组(27例),收集两组人员社会人口学、临床特征资料,采用贝克抑郁自评问卷(Beck depression inventory,BDI)、失眠严重程度量表(insomnia severity index,ISI)和军人社会支持评定量表(social suport rate scale for Chinese military personnel,SSRS-M)进行评估,并对血清5-羟色胺(5-hydroxytryptamine,5-HT)和脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)浓度进行测定,比较两组之间差异,通过多因素logistic回归分析了解该类人群自杀未遂的危险因素。结果 与非自杀未遂组相比,自杀未遂组既往多次住院者比例更高(57.58%vs 29.63%,P<0.05)、有更多的创伤经历(66.67%vs 40.74%,P<0.05)、自杀意念更加强烈(72.73%vs 37.04%,P<0.01),且自杀计划(90.91%vs 59.26%,P<0.01)和非自杀性自伤(non-suicidal self-injury,NSSI)行为(93.94%vs 48.15%,P<0.01)更常见,差异均有统计学意义(均P<0.05);自杀未遂组SSRS-M总分明显低于非自杀未遂组[(24.85±6.48)分vs(28.70±7.15)分,P<0.05];自杀未遂组血清BDNF浓度更低[418.26(269.18,606.62)ng/L vs537.46(412.04,784.92)ng/L,P <0.05]。Logistic回归分析显示,存在NSSI行为(OR=13.06)和低血清BDNF浓度(OR=0.97)是军人精神障碍患者自杀未遂的主要危险因素(均P<0.05)。结论 NSSI行为和低血清BDNF浓度水平可能是军人精神障碍患者发生自杀未遂的独立危险因素,可将其作为防自杀早期预警信号,对军人自杀防控有重要意义。

Objective To analyze the risk factors of attempted suicide in young male soldiers with mental disorders,and provide reference for early prevention and control of suicide in military personnel.Methods From June 2021 to March 2022,60 young male military personnel diagnosed with mental disorders were enrolled consecutively,divided into attempted suicide group(33 cases)and non attempted suicide group(27 cases).Sociodemographic and clinical characteristics data of the two groups were collected,and Beck depression inventory(BDI),insomnia severity index(ISI),and military social support rate scale for Chinese military personnel(SSRS-M)were used to evaluate serum serotonin(5-hydroxytryptamine).The concentrations of droxytryptamine(5-HT)and brain-derived neurotrophic factor(BDNF)were measured to compare the differences between the two groups.Multiple logistic regression analysis was used to understand the risk factors for attempted suicide in this population.Results Compared with the non attempted suicide group,the attempted suicide group had a higher proportion of previous multiple hospitalizations(57.58%vs 29.63%,P<0.05),more traumatic experiences(66.67%vs 40.74%,P<0.05),stronger suicidal ideation(72.73%vs 37.04%,P<0.01),and more common suicidal plans(90.91%vs 59.26%,P<0.01)and non suicidal self injury(NSSI)behaviors(93.94%vs 48.15%,P<0.01),with statistically significant differences(all P<0.05).The total score of SSRS-M in the attempted suicide group was significantly lower than that in the non attempted suicide group[(24.85±6.48)points vs(28.70±7.15)points,P<0.05].The serum BDNF concentration in the attempted suicide group was lower[418.26(269.18,606.62)ng/L vs 537.46(412.04,784.92)ng/L,P<0.05].Logistic regression analysis showed that the presence of NSSI behavior(OR=13.06)and low serum BDNF concentration(OR=0.97)were the main risk factors for attempted suicide in military patients with mental disorders(both P<0.05).Conclusions NSSI behavior and low serum BDNF levels may be independent risk factors for attempted suicide in military patients with mental disorders,and can be used as early warning signals for suicide prevention and control,which is of great significance for military suicide prevention and control.