生活事件、家庭环境及应对方式对青少年首次抑郁发作患者自伤行为的影响

Effects of life events,family environment and coping style on self-injury behavior in adolescents with first-episode depression

目的探讨生活事件、家庭环境及应对方式与青少年首次抑郁发作患者自伤行为的关系。方法选取2019年7月—2022年12月在郑州大学第一附属医院精神科就诊的青少年首次抑郁发作患者110例。依据是否伴有自伤行为,分为不伴自伤组(n=54)和伴自伤组(n=56)。采用一般临床资料调查表、青少年生活事件量表(adolescent self-rating life events checklist,ASLEC)、家庭环境量表(family environment scale-Chinese version,FES-CV)、简易应对方式(simplified coping style questionnaire,SCSQ)、24项汉密尔顿抑郁量表(24 items Hamilton depression scale,HAMD-24)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、90项症状清单量表(symptom checklist-90,SCL-90)对2组患者进行评估。运用SPSS 25.0统计学软件对入组数据进行t检验、χ^(2)检验、二元Logistic回归分析。结果110例患者中56例(50.9%)存在自伤行为。伴自伤组与不伴自伤组在ASLEC[(51.04±5.99)分,(48.02±6.86)分]、亲密度[(3.70±1.85)分,(4.59±1.60)]、情感表达[(3.84±1.80)分,(4.69±1.96)分]、积极应对方式[(15.84±5.85)分,(18.22±4.84)分]、消极应对方式[(12.50±3.23)分,(11.06±3.64)分]、HAMA[(20.63±2.86)分,(19.48±2.55)分]评分差异具有统计学意义(t=-2.46,2.72,2.36,2.32,-2.20,-2.21,均P<0.05)。二元Logistic回归分析显示青少年生活事件(B=0.079,OR=1.083,95%CI=1.008~1.163,P=0.030)、消极应对方式(B=0.173,OR=1.188,95%CI=1.033~1.367,P=0.016)、HAMA(B=0.225,OR=1.252,95%CI=1.057~1.482,P=0.009)为自伤行为的危险因素,亲密度(B=-0.264,OR=0.768,95%CI=0.593~0.995,P=0.046)、积极应对方式(B=-0.092,OR=0.912,95%CI=0.834~0.997,P=0.044)为自伤行为的保护因素。结论青少年首次抑郁发作患者自伤行为可能与青少年负性生活事件、早期不良家庭环境及应对方式有关。

Objective To explore the effects of life events,family environment and coping style on self-injury behavior in adolescents with first-episode depression.Methods From July 2019 to December 2022,a total of 110 adolescent patients with first-episode depression were selected in the Psychiatry Department of the First Affiliated Hospital of Zhengzhou University.According to whether the patients had self-injury behavior,the patients were divided into group without self-injury(n=54)and group with self-injury(n=56).Patients in the two groups were evaluated by a general clinical data questionnaire,adolescent self-rating life events checklist(ASLEC),family environment scale-Chinese version(FES-CV),simplified coping style questionnaire(SCSQ),24 items Hamilton depression scale(HAMD-24),Hamilton anxiety scale(HAMA)and 90 symptom checklist-90(SCL-90).Statistical analysis including t-test,χ^(2)test and binary Logistic regression analysis were performed on the enrolled data by SPSS 25.0 statistical software.Results Among 110 patients,there were 56 patients(50.9%)exhibited self-injury behavior.The scores of ASLEC(51.04±5.99,48.02±6.86),intimacy(3.70±1.85,4.59±1.60),emotional expression(3.84±1.80,4.69±1.96),positive coping styles(15.84±5.85,18.22±4.84),negative coping styles(12.50±3.23,11.06±3.64),and HAMA(20.63±2.86,19.48±2.55)showed statistically significant differences between the group with and without self-injury(t=-2.46,2.72,2.36,2.32,-2.20,-2.21,all P<0.05).Binary Logistic regression analysis showed that life events(B=0.079,OR=1.083,95%CI=1.008-1.163,P=0.030),negative coping style(B=0.173,OR=1.188,95%CI=1.033-1.367,P=0.016),HAMA(B=0.225,OR=1.252,95%CI=1.057-1.482,P=0.009)were risk factors for self-injury,while intimacy(B=-0.264,OR=0.768,95%CI=0.593-0.995,P=0.046)and positive coping styles(B=-0.092,OR=0.912,95%CI=0.834-0.997,P=0.044)were protective factors for self-injury.Conclusion The self-injury behavior of adolescents with first-episode depression may be related to negative life events,early adverse family environment and coping style.