青少年抑郁情绪与自杀意念的关系:失眠的中介作用

Relationship between adolescent depression and suicidal ideation:the mediating role of insomnia

目的探究失眠问题在青少年抑郁和自杀意念(Suicidal ideation,SI)之间的作用,为青少年抑郁的SI干预提供依据。方法本研究为横断面研究,共纳入739名13~25岁单相/双相抑郁患者。采用阿森斯失眠量表,汉密尔顿焦虑量表,汉密尔顿抑郁量表分别评估患者的失眠,焦虑,抑郁水平。根据哥伦比亚自杀严重程度量表将患者分为SI组和非自杀意念组,比较组间差异性,通过相关分析检验失眠与焦虑,抑郁水平及SI严重程度的相关性,采用回归分析检验失眠对SI的影响,通过中介效应分析说明失眠在青少年抑郁和SI之间的中介作用。结果失眠与焦虑,抑郁及SI呈显著相关性(P<0.01);将年龄,性别,起病年龄,受教育程度,焦虑,抑郁纳入协变量后,失眠对SI风险的影响仍显著(OR=1.07,95%CI:1.02,1.12,P<0.01);失眠在抑郁水平和SI风险之间起部分中介作用,中介效应占比为41.10%。结论在青少年群体中,抑郁症状可通过失眠的中介作用间接影响SI风险。

Objective To explore the role of insomnia in youth depression and suicidal ideation(SI),and to provide evidence for the intervention of SI in youth depression.Methods This is a cross-sectional study,a total of 739 patients aged 13-25 years with unipolar/bipolar depression were enrolled.Athens Insomnia Scale,Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale were used to evaluate the insomnia,anxiety,and depression levels of the patients.According to the Columbia-Suicide Severity Rating Scale,patients were divided into SI group and non-suicidal ideation group.The differences between the groups were compared.Correlation analysis was used to examine the correlation between insomnia,anxiety,depression and SI severity.Regression analysis was used to examine the influence of insomnia on SI,and mediation effect analysis was used to explain the mediating role of insomnia between depression and SI in adolescents.Results Insomnia was significantly correlated with anxiety,depression,and SI(P<0.01).After age,gender,age of onset,education level,anxiety,and depression were included as covariates,insomnia was still significantly positively correlated with SI(OR=1.07,95%CI:1.02,1.12,P<0.01).Insomnia played a partial mediating role between the level of depression and the risk of SI,and the mediating effect accounted for 41.10%.Conclusion In youth,depression indirectly increase the risk of SI by aggravating insomnia.