2017—2021年重度抑郁症患者院内自杀行为的调查及影响因素分析

2017 to 2021 suicidal behavior in hospitalized patients with major depression and the influencing factors

【目的】分析2017—2021年河北省某医院重度抑郁症患者院内自杀行为现状及影响因素。【方法】选取2017年1月—2021年7月该院收治的重度抑郁症患者1000例作为研究对象,调查患者自杀行为现状。依据调查结果将患者分为自杀行为组和无自杀行为组,分析影响患者自杀行为的相关因素。【结果】重度抑郁症患者出现院内自杀行为511例(51.10%),其中自杀意念患者271例(27.10%),自杀未遂患者186例(18.60%),自杀死亡患者54例(5.40%);无自杀行为患者489例(48.90%)。单因素分析显示自杀行为组和无自杀行为组在年龄、性别、婚姻状况、兴趣或愉快感丧失、焦虑、无价值感或自罪感、睡眠状况、性格、抑郁发作次数、妄想症方面差异具有统计学意义(均P<0.05)。Logistic多因素回归分析显示年龄≤28岁(OR=1.54)、女性(OR=1.93)、焦虑(OR=1.61)、无价值感或自罪感(OR=1.85)及妄想症(OR=2.15)是重度抑郁症患者发生自杀行为的独立影响预测因子(均P<0.05)。【结论】重度抑郁症患者院内自杀行为的发生率较高,发病年龄早、女性、焦虑、无价值感或自罪感、抑郁发作次数较多及妄想症是重度抑郁症患者发生自杀行为的独立危险预测因子,临床应据此进行干预以降低患者自杀行为的发生。

[Objective]To analyze the suicidal behavior in hospitalized patients with major depression and its influencing factors.[Methods]A total of 1000 patients with major depression admitted to our hospital from January 2017 to July 2021 were selected as the research subjects to investigate the status quo of suicidal behavior of the enrolled patients.According to the survey results,the patients were divided into suicidal behavior group and non-suicidal behavior group,and the related factors affecting their suicidal behavior.[Results]A total of 511 cases(51.10%)of the patients with major depression committed suicide in hospital,including 271 cases(27.10%)of suicidal ideation,186 cases(18.60%)of attempted suicide,and 54 cases(5.40%)of suicide death.489 patients(48.90%)did not commit suicide.Univariate analysis showed that there were significant differences in age,gender,marital status,loss of interest or pleasure,anxiety,sense of worthlessness or selfguilt,sleep status,personality,depressive episodes and paranoia between the suicidal behavior group and the non-suicidal behavior group(all P<0.05).Logistic multifactorial regression analysis showed that age≤28 years(OR=1.54),female(OR=1.93),anxiety(OR=1.61),sense of worthlessness or self-guilt(OR=1.85)and paranoia(OR=2.15)were all independent predictors of suicidal behavior in the patients with major depression.[Conclusion]The incidence of nosocomial suicide in patients with major depression is high.Early onset age,female,anxiety,sense of worthlessness or self-guilt,more depressive episodes and paranoia are independent risk predictors of suicide in patients with major depression.This finding can be used for clinical intervention to reduce the occurrence of suicide in patients.