儿童青少年精神障碍患者家长自杀倾向及危险因素分析

Suicidal tendencies and risk factors among parents of children and adolescents with psychiatric disorders:a predictive model

目的探讨儿童青少年精神障碍患者家长自杀倾向及其危险因素,并构建自杀倾向的预测模型。方法采用横断面调查的方法,收集2022年8月至2023年7月就诊于安徽省内两所医院共299名儿童青少年精神障碍家长的社会人口学资料,并采用自杀相关的标准化问题、患者健康问卷-9(PHQ-9)以及多伦多述情障碍量表(TAS-20)分别评估调查对象自杀倾向、抑郁症状及述情障碍的程度。结果自杀倾向的总体检出率为15.4%,其中自杀意念、自杀计划和自杀未遂检出率分别为11.0%、3.3%和8.0%。Logistic回归分析结果显示,躯体疾病史、抑郁症状、述情障碍以及情感辨别不能因子与较高的自杀倾向风险有关(均P<0.05)。基于回归分析结果,构建预测患儿家长自杀倾向风险预测模型,并绘制受试者工作特征(ROC)曲线下面积(AUC)为0.80(95%CI:0.72~0.87,P<0.05)。结论儿童青少年精神障碍患者家长自杀倾向检出率较高,提示临床上在注重青少年精神障碍患者的同时,亦不能忽视患儿家长的心理健康,应加强对患儿和家长的护理,必要时应提供个体化的综合干预措施。

Objective To explore the suicidal tendencies and risk factors among parents of children and adolescents with psychiatric disorders and to develop a predictive model for suicidal tendencies.Methods A cross-sectional survey was conducted from August 2022 to July 2023,involving 299 parents of children and adolescents with psychiatric disorders from two hospitals in Anhui Province.Sociodemographic data were collected,and suicidal tendencies,depressive symptoms,and alexithymia were assessed using standardized suicide-related questions,the Patient Health Questionnaire-9(PHQ-9),and the Toronto Alexithymia Scale-20(TAS-20),respectively.Results The overall prevalence of suicidal tendencies was 15.4%,with the rates of suicidal ideation,planning,and attempts being 11.0%,3.3%,and 8.0%,respectively.Logistic regression analysis revealed that a history of physical illness,depressive symptoms,alexithymia,and dfficulty identifying feelings were associated with a higher risk of suicidal tendencies(all P<0.05).Based on the regression analysis results,a predictive model for the risk of suicidal tendencies among parents was developed.The area under the receiver operating characteristic(ROC)curve(AUC)was 0.80(95%CI:0.72-0.87,P<0.05).Conclusion The high prevalence of suicidal tendencies among parents of children and adolescents with psychiatric disorders underscores the need for clinicians to pay attention to the mental health of both the patients and their parents.It is crucial to enhance care for both the children and their parents and to provide individualized comprehensive interventions when necessary.