On the role of impulsivity and decision-making in suicidal behavior

Suicide risk constitutes a complex set of interacting demographic, clinical, psychobiological and environmental variables. Impulsivity is a long-known risk factor for suicide attempts. However, research based on clearer conceptual refinement in this area is imperative. One emerging field of study is that of decision-making. Impulsivity involves a failure of higher-order control, including decision-making. Using standardized operational definitions that take into consideration relevant aspects of impulsivity, including state- and trait-components and a deeper understanding of the process of decision-making in the suicidal mind, we may come a step closer to understanding suicidality and winning the fight in this scourge of human suffering.

Suicide risk in juvenile open angle glaucoma patients

AIM:To investigate the association between juvenile open angle glaucoma(JOAG)and mental health among Koreans.METHODS:This study used nationally representative data from the 8th Korea National Health and Nutrition Examination Survey(KNHANES)2021.Glaucoma diagnosis followed the International Society of Geographical and Epidemiological Ophthalmology criteria based on glaucomatous structural defects,visual field defects,corrected vision,and intraocular pressure.As outcomes,suicidal behaviors,psychiatric counseling,and depression were evaluated through mental health questionnaires.Odds ratios(ORs)with 95%confidence intervals(CIs)were estimated using logistic regression models,adjusting for covariates.RESULTS:Among 7090 participants,3446 met the inclusion criteria for analysis,and 88(2.6%)were diagnosed with open angle glaucoma(OAG).After adjusting for age,sex,and best-corrected visual acuity(VA),participants with OAG were revealed to have significantly higher odds of suicidal behaviors(i.e.,ideation,planning,or attempts)compared with those without OAG(OR:2.70;95%CI:1.12-6.54;P=0.028).This association remained significant after further adjustments for socioeconomic status,lifestyle factors,and presence of chronic conditions(P=0.031 and 0.035,respectively).However,there was no significant difference for the other two outcomes,psychiatric counseling and depression.An age-stratified analysis revealed a stronger association between OAG and suicidal behaviors in younger JOAG participants(<40y)than in older OAG participants(≥40y;OR:3.80 vs 2.22;95%CI:0.79-18.22 vs 0.56-8.80,respectively).CONCLUSION:OAG patients show a higher risk of suicidal behaviors than those without glaucoma particularly in JOAG patients.

Associations among depression, suicidal behavior, and quality of life in patients with human immunodeficiency virus

AIM: To investigate the potential associations among major depression, quality of life, and suicidal behavior in human immunodeficiency virus(HIV) patients. METHODS: A detailed MEDLINE search was carried out to identify all articles and book chapters in English published from January 1995 to January 2015. RESULTS: Based on the main findings, the prevalence of major depressive disorder(MDD) ranged from 14.0% to 27.2%. Furthermore, the prevalence of suicidal ideation varied from 13.6% to 31.0% whereas, attempted suicides were reported to range from 3.9% to 32.7%. Interestingly, various associated risk factors for both depression and suicide were identified in HIV patients. Finally, consistent associations were reported among MDD, suicidal ideation, and poor quality of life in individuals living with HIV. CONCLUSION: Although additional studies are needed to elucidate this complex association, our results suggest the importance of early detection of both MDD and suicidality in patients living with HIV.

Characteristics,causality,and suicidal behavior:a qualitative study of family members with suicide history in Wonogiri,Indonesia

Objective:This study explored the characteristics,causality,and suicidal behavior among family members with suicide history in Wonogiri,Central Java,Indonesia.Methods:Qualitative semistructured interviews were conducted with 15 family members who had made suicide attempts.The interviews directly explored the relationships among characteristics,causality,and suicidal behavior.The research data were analyzed using the Miles and Huberman approach.Results:The results indicate that there are relationships among characteristics,causality,and suicidal behaviors.The characteristics contributing to suicide attempts were male gender,age(adolescence and old age),lack of religious activities,introvert nature,low economic status,chronic diseases,unemployment,and a history of family members with suicide attempts.The causality of suicide was joblessness,economic crisis,unemployment,family conditions,personality disorder,depression,sickness,and suicide ideation.Conclusions:The findings highlight the relationships among characteristics,causality,and suicidal behaviors.Suicide occurs when individuals have some problems that they cannot solve because of the lack of family support.The causal factors were related to one another,which caused the suicidal behavior.One of the most effective suicide prevention strategies is educating the community on how to identify suicidal signs and increase social supports.

Suicidal behavior-advances in clinical and neurobiological research and improvement of prevention strategies

Suicide is the 14^(th)leading cause of death worldwide.It is responsible for 1%-5%of all mortality.This article highlights the latest developments in universal,selective,and indicated prevention strategies.Concerning universal suicide prevention,current research has shown that strategies such as restricting access to lethal means(e.g.,control of analgesics and hot-spots for suicide by jumping)and school-based awareness programs are most efficacious.Regarding selective prevention,substantial progress can be expected in psychological screening methods for suicidal behavior.The measurement of implicit cognition proved to be more valid in predicting future suicide attempts than classic clinical assessment.Latest developments are smartphone-based interventions and realtime monitoring of suicidal behavior.Great effort has been made to establish valid neurobiological screening methods(e.g.,genetic and epigenetic risk factors for suicide,hypothalamic-pituitary-adrenal axis)without yielding a major breakthrough.Potentially,multiple biomarkers rather than a single one are necessary to identify individuals at risk.With regard to indicated prevention in form of psychopharmacological treatment,recent pharmacoepidemiological studies and meta-analyses have supported a protective role of antidepressants,lithium,and clozapine.However,the data concerning a specific anti-suicidal effect of these drugs are currently not consistent.Promising results exist for ketamine in reducing suicidal ideation,independently of its antidepressant effect.Concerning psychotherapy,recent findings suggest that psychotherapeutic interventions specifically designed to prevent suicide re-attempts are most efficacious.Specifically,cognitive behavioral therapy and psychodynamic therapy approaches proved to decrease the number of suicide re-attempts significantly.

Psychiatric hospitalization during the two SARS-CoV-2 pandemic waves:New warnings for acute psychotic episodes and suicidal behaviors

BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)pandemic have represented a dramatic health emergency characterized by significant consequences on mental health.Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant"sentinel events"for assessing the mental health response to an unprecedented stressful event.AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna"Maggiore"General Hospital Psychiatric Ward(GHPW)between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years.The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.METHODS This observational and retrospective study collected information on admission to the GHPW at the"Maggiore"Hospital in Bologna in the index periods defined as follows:the first period between February 24,2020 and April 30,2020(first epidemic wave)and the second period between October 8,2020,and January 7,2021(second pandemic wave).Absolute numbers and proportion of admitted patients,their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years.No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.RESULTS During the first wave,there was a significant reduction in hospitalization rates,although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders.During the second wave,hospitalization rates reached those recorded during the same period of the previous 3 years,mainly due to the rise of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressor-related disorders and suicidal behaviors.CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse,even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses.In the medium-long term(as in the second pandemic wave),the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures.Indeed,during the second wave of the SARS-CoV-2 pandemic,an increase in total hospitalization rate,suicidal behaviors and the incidence rate of bipolar and related disorders,depressive disorders,anxiety disorders,trauma-and stressorrelated disorders was observed.

Effect of dialectical behavior therapy on the serum neurotransmitters and cytokines in depression patients with suicidal tendency

Objective: To explore the effect of dialectical behavior therapy on the serum neurotransmitters and cytokines in depression patients with suicidal tendency. Methods: A total of 98 depression patients with suicidal tendency who were treated in the hospital between August 2014 and August 2017 were collected and divided into the control group (n=49) and the research group (n=49) by random number table. Control group received routine drug therapy, and study group received dialectical behavior therapy combined with drug therapy. The differences in serum levels of monoamine neurotransmitters, nerve function indexes and acute phase proteins were compared between the two groups of patients. Results: After treatment, serum NE, 5-HT and DA levels of research group were higher than those of control group;serum MBP and NSE levels of research group were lower than those of control group while BDNF level was higher than that of control group;serum Tf level of research group was higher than that of control group while Hp level was lower than that of control group. Conclusion: Dialectical behavior therapy intervention can effectively optimize the nerve function and improve the overall state of depression patients with suicidal tendency.

大学生自杀行为影响因素的分类决策树分析

为了识别大学生自杀行为的风险和保护因素。对在校大学生实施感恩问卷、自我控制双系统量表、自杀问卷及人口学信息调查,获得有效数据11288份,进行分类决策树分析。结果显示:大学生近一年内自杀意念发生率17.1%,近半年内自杀行为发生率3.8%。分类决策树分析发现,自杀意念为根节点,感恩、冲动、控制、家庭阶层、是否独生均为重要的子节点(AUC=0.959)。结论:自杀意念是大学生自杀行为最重要的近端风险因素,冲动为中端风险因素,感恩特质和适度控制分别为远端保护因素;低社会家庭阶层、中高阶层家庭的非独生子女大学生由自杀意念转变自杀行为的风险较高。

积极反刍思维训练对青少年伴非自杀性自伤行为抑郁症患者情绪调节策略的影响

目的:探讨积极反刍思维训练对青少年抑郁症患者非自杀性自伤行为(NSSI)及情绪调节策略的干预效果。方法:纳入南京脑科医院2021年3月至2022年6月有NSSI青少年抑郁症患者167例,按随机数字表法分为对照组(n=84)和干预组(n=83)。对照组实施精神科常规治疗及护理;干预组除常规治疗护理措施外,实施积极反刍思维训练。采用SPSS22.0对数据进行统计分析,采用t检验比较差异,计算Cohen’s D值估计差异效应量。结果:干预后干预组积极反刍思维、情感表达、自我负强化、表达抑制、认知重评策略分量表得分与对照组差异有统计学意义(P<0.05或P<0.01),情感表达、自我负强化、认知重评分量表Cohen’s D值达到中等效应(0.5≤D≤0.8);干预后3个月,干预组各量表分与对照组差异具有统计学意义(P<0.05或P<0.01),Cohen’s D值均有提升,认知重评策略分量表达到较大效应(D>0.8),积极反刍思维、情感表达、利己社交、自我负强化、表达抑制分量表达到中等效应(0.5≤D≤0.8),消极反刍思维分量表减分值效应较小(0.2≤D≤0.5)。结论:积极反刍思维训练有利于改善青少年抑郁症患者情绪调节策略,减少非自杀性自伤行为,且随着时间推移,效应逐步提升。

青少年抑郁症非自杀性自伤行为的影响因素

目的分析青少年抑郁症与非自杀性自伤(non-suicidal self-injury,NSSI)行为的关系及预防对策。方法114例2021年1月-2023年1月南通市第一人民医院收治的青少年抑郁症患者,依据是否伴有NSSI分为伴有NSSI组(59例)和不伴有NSSI组(55例)。统计青少年抑郁症患者NSSI的单因素,并分析其高危因素。结果伴有NSSI组与不伴有NSSI组有无焦虑、抑郁程度、有无童年家庭功能不全、有无童年虐待、是否受过校园欺凌比较,差异有统计学意义(P<0.05);有焦虑、重度抑郁、有童年家庭功能不全、有童年虐待、受过校园欺凌是青少年抑郁症患者NSSI的独立高危因素(P<0.05)。结论青少年抑郁症患者NSSI的高危因素包括有焦虑、重度抑郁、有童年家庭功能不全、有童年虐待、受过校园欺凌等,临床可据此给予青少年抑郁症患者针对性预防对策,以减少青少年抑郁症患者NSSI的发生。

抑郁症自杀行为发生机制及预测研究新进展

自杀是个体蓄意或自愿采取各种手段结束自己生命的行为。全球年自杀病死率约为16/100000,即每年大约有703000人死于自杀,是人类死亡的首位原因。自杀多发生于精神疾病患者中,最常见的为抑郁症。研究抑郁症自杀行为发生的机制对于制定从自杀意念到自杀行为的预防措施可提供重要的数据支持。自杀行为发生的相关因素包括社会、心理、生物遗传等多种相关因素,本文旨在针对抑郁症自杀行为的生物学机制包括与自杀行为相关的磁共振研究、与自杀行为相关的神经认知研究、机器学习、生态瞬时评价及数字表型研究进展进行综述,以期为开发自杀风险早期识别指标提供借鉴。

自杀行为问卷中文版的信效度检验和临床划界分

目的评估自杀行为问卷-修订版(Suicidal Behaviors Questionnaire-Revised,SBQ-R)在中国大学生中的信效度,并确定筛查大学生临床群体自杀风险的最佳划界分。方法共招募488名大学生,其中第一次采用整群抽样的方法招募366人,填写中文版SBQ-R、心理痛苦量表中文版和生活满意度量表,4周后抽取其中45名被试重测;第二次采用方便取样的方法招募122人,采用访谈加问卷的形式,以简明国际神经精神访谈的自杀模块为金标准划定划界分。结果(1)验证性因子分析结果支持了该问卷的单维性;(2)SBQ-R的Cronbach’sα系数为0.76,分半信度和4周后的重测信度分别为0.79和0.93;(3)SBQ-R得分与心理痛苦结果显著正相关,与生活满意度量显著负相关,表明该量表具有良好的效标关联效度;(4)受试者工作特征(ROC)曲线分析结果表明,划界分为9分时,敏感度和特异度最高,ROC曲线下面积(AUC)为0.916。结论中文版SBQ-R具有良好的信效度,可以作为评估中国大学生群体自杀风险的有效工具,且SBQ-R筛查自杀风险的最佳截断值为9分。

青少年抑郁症患者人格特征与非自杀性自伤行为的相关性分析

目的探讨青少年抑郁症患者的人格特征与非自杀性自伤行为之间的相关性,以增进对抑郁症患者心理健康风险的理解。方法研究于2021年9月至2023年9月在武汉市精神卫生中心进行,共纳入138例首发中重度青少年抑郁症患者,将患者分为无自伤自杀行为组(n=25)、非自杀性自伤(NSSI)组(n=78)和自杀未遂(SA)组(n=35)。通过汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)-24以及其他心理评估工具,收集一般资料和神经质人格得分、负性生活事件、情绪状态、社会心理因素等数据。采用统计学方法进行相关性和回归分析研究人格特征与非自杀性自伤行为之间的关系。结果无自伤自杀行为组、非自杀性自伤行为组和自杀行为组在内外倾向、精神质、神经质和掩饰性等人格特征方面存在显著差异,且非自杀性自伤行为组和自杀行为组的评分普遍高于无自伤自杀行为组(P<0.05);自伤行为评分在这三组中也有显著差异,尤其是自杀行为组评分最高,但在生活事件评分方面则无显著差异;焦虑、抑郁、童年期创伤、应激生活事件和自尊方面的评分在三组间均有显著差异,其中自杀行为组在焦虑、抑郁、童年期创伤和应激生活事件评分上最高,但在自尊评分上最低(P<0.05);内外倾向、精神质、神经质和掩饰性与非自杀性自伤行为显著相关,且多元回归分析结果显示这些因素以及焦虑、抑郁、童年期创伤、应激生活事件和自尊是非自杀性自伤行为的独立影响因素,且内外倾向的最佳预测阈值为-10.5%。结论研究揭示了青少年抑郁症患者人格特征与非自杀性自伤行为之间的相关性。对于临床实践和干预策略,了解这些关系有助于更好地识别高风险群体并提供个性化的心理健康支持。

抑郁发作患者认知功能对自杀行为的影响

目的本研究旨在分析抑郁发作患者自杀意念和自杀行为的认知功能差异性,探索认知功能对自杀行为的影响。方法选取来自首都医科大学附属北京安定医院就诊的抑郁发作患者133例,依据两周内是否存在自杀行为和意念分为以下3组:无自杀症状的抑郁对照组(depression control,DC组)、伴自杀意念组(suicidal ideation,SI组)和伴自杀行为组(suicide attempt,SA组)。采用汉密尔顿抑郁量表17项(Hamilton Depression Scale-17 item,HAMD-17)、自杀意念量表(the Scale for Suicide Ideation,SSI)和精神分裂认知功能成套测验共识版(MATRICS Consensus Cognitive Battery,MCCB)分别评估患者的临床症状和认知功能。采用Logistic回归对各相关因素进行分析。结果3组HAMD-17总分比较差异有统计学意义(F=59.661,P<0.001),事后比较发现SA组和SI组HAMD-17总分显著高于DC组。MCCB结果显示,DC组言语学习和记忆分数显著高于SI组(P<0.05),DC组和SA组推理和问题解决分数显著高于SI组(P<0.05)。Logistic回归结果显示,推理和问题解决能力(P=0.022,OR=1.067,95%CI:1.009~1.127)、认知障碍因子(P=0.001,OR=1.739,95%CI:1.238~2.443)是抑郁发作患者发生自杀行为的独立危险因素,复发(P=0.003,OR=0.100,95%CI:0.022~0.458)和社会认知(P=0.033,OR=0.953,95%CI:0.912~0.996)是抑郁发作患者发生自杀行为的保护性因素。结论认知功能缺陷是影响抑郁发作患者产生自杀行为的重要因素。

校园欺凌与攻击性行为对青少年非自杀性自伤的双重影响:一项横断面研究

目的探讨青少年非自杀性自伤(non-suidical self-injury,NSSI)的发生和发展机制,关注校园欺凌和攻击性行为与青少年NSSI之间的关联,以期为预防和干预这一问题提供理论依据和实践建议。方法采用横断面研究设计,研究对象为15987位中国辽宁、上海和江西三个省的初高中学生,代表了不同的社会、经济和文化背景。通过问卷调查法收集数据,并运用相关分析、回归分析和结构方程模型等统计方法进行分析,以揭示各变量间的关系及相互作用。结果校园欺凌与NSSI呈正向关系(非标准化系数=0.420,标准化系数=0.247,Z=18.123,P<0.001),欺凌程度越高,自伤风险也越高。攻击性行为与NSSI之间同样存在正向关系(非标准化系数=0.230,标准化系数=0.201,Z=14.301,P<0.001),攻击性行为越强烈,自伤风险也越高。校园欺凌对攻击性行为的影响显著(非标准化系数=1.052,标准化系数=0.708,Z=75.223,P<0.001),欺凌程度越高,攻击性行为也越严重。结构方程模型结果表明,模型在解释校园欺凌、攻击性行为与青少年NSSI关系方面具有较好的拟合效果。结论研究发现,校园欺凌和攻击性行为对青少年NSSI具有显著影响,且青少年的欺凌和攻击性行为存在地区差异。预防和干预措施应综合学校、家庭和社会力量,加强师生间沟通,提高教师对问题行为的识别和干预能力,增进家长对青少年心理健康的关注,以降低青少年NSSI风险。

终末期癌症患者照顾者自杀行为及其相关因素

目的:了解终末期癌症患者照顾者的自杀行为,并探讨睡眠相关症状、生活质量、抑郁症状与自杀行为的关系。方法:选取213例终末期癌症患者,采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)、病人健康问卷(PHQ-9)、睡眠相关症状3个标准化问题及自杀行为3个标准化问题对其照顾者进行调查。结果:自杀行为检出率为16.43%。终末期癌症患者照顾者生活质量得分与抑郁症状得分、睡眠相关症状、自杀行为呈负相关(r=-0.66、-0.29、-0.44,均P<0.01),抑郁症状得分、睡眠相关症状、自杀行为两两之间均呈正相关(r=0.27、0.51、0.10,均P<0.01)。生活质量得分在抑郁症状得分和睡眠相关症状关系中的中介效应有统计学意义(r=0.29),中介效应占总效应的55%;抑郁症状得分在睡眠相关症状对自杀行为的影响中起完全中介效应(r=0.34,P<0.05)。结论:终末期癌症患者照顾者自杀行为检出率高,睡眠相关症状、生活质量、抑郁症状可能是自杀行为的相关因素。

青少年“理想-现实”自我差异对非自杀性自伤行为的影响:有调节的中介模型

目的:探讨青少年“理想-现实”自我差异对非自杀性自伤行为的影响以及反刍思维和心理弹性在二者中的作用。方法:使用青少年“理想-现实”自我差异量表、青少年心理弹性量表、反刍思维量表以及青少年自我伤害行为问卷对470名中学生进行调查。结果:1青少年“理想-现实”自我差异、反刍思维、非自杀性自伤行为两两显著正相关(r=0.21~0.50,P<0.01),心理弹性与青少年“理想-现实”自我差异、反刍思维、非自杀性自伤行为均呈显著负相关(r=-0.50~-0.28,P<0.01);2青少年“理想-现实”自我差异可显著正向预测非自杀性自伤行为(β=0.19,P<0.001),并且反刍思维在二者之间起完全中介作用,中介效应量为0.16;③心理弹性在中介作用的后半段起调节作用(β=-0.17,P<0.001),即随着心理弹性的提高,反刍思维对青少年非自杀性自伤行为的正向预测作用减弱(心理弹性低分组β=0.43,P<0.001 vs心理弹性高分组β=0.09,P>0.05)。结论:青少年“理想-现实”自我差异不仅可以直接预测非自杀性自伤行为,还可通过反刍思维间接对非自杀性自伤行为产生影响,心理弹性在这一中介作用的后半段起调节作用。

老年人自杀行为真实体验质性研究的Meta整合

目的系统评价老年人自杀行为的真实体验,为老年人自杀的预防与干预提供参考。方法计算机检索中英文数据库,并辅以人工检索,检索老年人自杀真实体验的质性研究,检索时限为建库至2023年7月。采用JBI循证卫生保健中心质性研究质量评价标准评价文献质量,以汇集性整合方法对结果进行整合。结果纳入11篇文献,提炼出37个研究结果,归纳出10个类别,最终整合得到3个整合结果,即老年人自杀行为影响因素的多元化,老年人面对自杀行为导致死亡结局的复杂心理,老年人自杀行为后的调节与应对。结论发生自杀行为的老年人存在复杂的心理体验。家庭、社区、养老机构及医疗机构相关人员应密切关注老年人身心健康及心理变化,根据个体差异性实施相应的干预方案。

青少年抑郁患者自杀行为现状及研究进展

抑郁症患者自杀行为是精神科最为重视的问题,也是目前社会最为棘手的难题。国内外统计资料表明,大多数青少年抑郁症患者中有自杀行为,且重症抑郁症的自杀危险率也逐年升高。本文针对青少年抑郁患者自杀行为现状及影响因素、干预措施做一综述,为后期制定该疾病早期防治措施以预防自杀行为发生提供参考。

九味镇心颗粒结合舍曲林对伴非自杀性自伤青少年抑郁症患者抑郁情绪、自伤水平及冲动行为的影响

目的 观察九味镇心颗粒结合舍曲林对伴非自杀性自伤青少年抑郁症患者抑郁情绪、自伤水平及冲动行为的影响。方法 前瞻性选取2022年1月至2023年2月潍坊市精神卫生中心收治的65例伴非自杀性自伤青少年抑郁症患者,按照奇偶数分组法分为舍曲林组(n=32)和联合组(n=33)。舍曲林组给予舍曲林治疗,联合组给予九味镇心颗粒结合舍曲林治疗。两组疗程均为8周。评估并比较两组治疗前和治疗8周后的自我伤害行为筛选量表评分、情绪调节困难量表(DERS)评分、汉密尔顿抑郁量表(HAMD)评分、抑郁自评量表(SDS)评分、Barratt冲动量表(BIS-II)评分差异,检测两组治疗前和治疗8周后的神经递质(5-羟色胺、P物质、皮质醇)水平,记录并比较两组不良反应。结果 治疗8周后,联合组的忧郁孤独、自残自杀、退缩与自我批评及总分分别为(5.82±1.47)、(2.56±0.78)、(2.95±0.95)、(15.57±3.11)分,均低于舍曲林组[(7.95±1.89)、(4.25±1.06)、(3.57±1.24)、(20.03±3.56)分],差异均有统计学意义(P<0.05),而攻击违纪、行为改变评分与舍曲林组比较,差异均无统计学意义(P>0.05)。治疗8周后,联合组的HAMD评分、SDS评分、DERS评分、BIS-Ⅱ评分分别为(11.74±3.04)、(28.78±4.12)、(105.85±15.43)、(24.17±3.86)分,均低于舍曲林组[(15.45±3.56)、(39.45±4.56)、(114.56±14.62)、(27.23±4.11)分],差异均有统计学意义(P<0.05)。治疗8周后,联合组5-羟色胺水平为(89.52±5.04)ng/mL,高于舍曲林组[(43.69±4.75)ng/mL],P物质、皮质醇水平分别为(37.95±7.44)ng/L、(72.25±18.89)μg/L,均低于舍曲林组[(46.54±8.12)ng/L、(95.85±21.04)μg/L],差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 九味镇心颗粒结合舍曲林可减轻伴非自杀性自伤青少年抑郁症患者抑郁情绪,减轻自伤和冲动行为,可能与调节神经递质有关。