Suicide Ideation and Its Associated Factors among Men in Selected Compounds of Lusaka, Zambia

Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.

Analysis of risk factors of suicidal ideation in adolescent patients with depression and construction of prediction model

BACKGROUND Major depressive disorder is a common mental illness among adolescents and is the largest disease burden in this age group.Most adolescent patients with depression have suicidal ideation(SI);however,few studies have focused on the factors related to SI,and effective predictive models are lacking.AIM To construct a risk prediction model for SI in adolescent depression and provide a reference assessment tool for prevention.METHODS The data of 150 adolescent patients with depression at the First People's Hospital of Lianyungang from June 2020 to December 2022 were retrospectively analyzed.Based on whether or not they had SI,they were divided into a SI group(n=91)and a non-SI group(n=59).The general data and laboratory indices of the two groups were compared.Logistic regression was used to analyze the factors influencing SI in adolescent patients with depression,a nomogram prediction model was constructed based on the analysis results,and internal evaluation was performed.Receiver operating characteristic and calibration curves were used to evaluate the model’s efficacy,and the clinical application value was evaluated using decision curve analysis(DCA).RESULTS There were differences in trauma history,triggers,serum ferritin levels(SF),highsensitivity C-reactive protein levels(hs-CRP),and high-density lipoprotein(HDLC)levels between the two groups(P<0.05).Logistic regression analysis showed that trauma history,predisposing factors,SF,hs-CRP,and HDL-C were factors influencing SI in adolescent patients with depression.The area under the curve of the nomogram prediction model was 0.831(95%CI:0.763–0.899),sensitivity was 0.912,and specificity was 0.678.The higher net benefit of the DCA and the average absolute error of the calibration curve were 0.043,indicating that the model had a good fit.CONCLUSION The nomogram prediction model based on trauma history,triggers,ferritin,serum hs-CRP,and HDL-C levels can effectively predict the risk of SI in adolescent patients with depression.

Depression and Suicidal Ideations among Prisoners of the Douala Central Prison

Introduction: The prison environment is a conducive environment for the development of psychiatric pathologies such as depression and suicidal ideation. To date, no related study has been conducted in Douala, Cameroon. We have therefore undertaken to study the prevalence of these pathologies and their related factors among inmates of the Douala Central Prison. Method: We conducted a cross-sectional study of 309 prisoners over a 6-month period from 1 January to 31 June 2022. This involved prisoners aged 18 years and over, who were consenting and able to read and write. Data were collected during individual interviews using a structured questionnaire. Depression was assessed by the BECK Short Form Depression Inventory and suicidal ideation was assessed by the MINI. These data were processed using the SPSS version 25.0 software. The related factors were studied in bivariate and multivariate analysis. Results: Most of the prisoners were male (97%), and more than half knew their criminal status. The prevalence of depression was 33.7% and that of suicide ideation was 22.7%. Among the factors associated with depression were receiving social visits and suicidal ideation. A history of physical/psychological abuse, repeated offences and prison violence were protective factors. Factors associated with suicidal ideation were the absence of social visits, physical abuse in childhood, smoking in prison and depression. Suicidal ideation was independently associated with depression as well as depression being independently associated with suicidal ideation. Conclusion: About 1/3 of the prisoners had depression and almost 1/4 had suicidal ideations. As a result of this and the related factors, there is a need to reorganize psychiatric care within our prison context.

Depression and Suicidal Ideations among Older Persons Living with HIV/AIDS in Mbarara City, Southwest Uganda

Background: Due to the increase in longevity and use of antiretroviral treatment, Uganda has had a growing population of older persons living with HIV/AIDS. However, there is a paucity of information on the mental health of the elderly living with HIV/AIDS. In this cross-sectional study, we determined the prevalence of, and associated factors for depression and suicidal ideation among older persons living with HIV/AIDS in Mbarara city, southwest Uganda. Methods: Older persons (150 females, 115 males), with mean age = 64.2 (±5.1) years, accessing health services from three purposively selected HIV/AIDS care centers in Mbarara city, southwest Uganda were recruited. Data on depression and suicidal ideation were collected using a Patient Health Questionnaire (PHQ-9) validated in Uganda, and a structured questionnaire was used to collect data on clinical and socio-demographic characteristics. Data were analysed using logistic regression. Results: Approximately 8.3% and 12.1% had depression and suicidal ideation, respectively. The factors associated with lowering the likelihood of depression were: an increase in the number of family members they stayed with and having no having any problems with their ARVs. On the other hand, earning more than 100,000 Uganda shillings was associated with reducing the risk of suicidal ideations among the participants. Conclusion: Approximately 8 to 12 in 100 older persons living with HIV/AIDS in Uganda have experienced depression or suicidal ideation. Family support and financial control were instrumental factors associated with depression and suicidal ideations, respectively. We recommended strengthening family structures and creating more avenues for financial independence among older persons living with HIV/AIDS to reduce the burden of depression, and suicidal behaviours among this vulnerable population.

Socio-Psychological Factors of Rising Trend of Suicidal Ideation among Indigenous Workforce: Evidence from Himalayan Range

Apart from socio-economic disparities,indigenous people of the Himalayan range in Asia face an increasing trend of suicides.The tragic suicidal events usually go unaddressed,and no strategies are presently in place to mitigate suicides in the future.This study aims to explain the prevailing causes of suicidal ideation to come up with some policy recommendations.Through a preliminary survey,we identified social stigma,social isolation,lack of healthcare facilities,and domestic violence as the potential reasons for suicidal ideation.We identified individuals with suicide ideation for further data collection to test the relationships between the identified variables and suicidal ideation.A quantitative,explanatory and cross-sectional design was used to test the hypotheses.Inferential statistics were applied to the data containing 314 responses,and the results revealed that all the predictive variables influence the formation of suicidal ideation.The study uncovered some new dimensions of social stigma and social isolation that are common among the indigenous people.The results also indicate that some domestic violence is socially acceptable and considered a normal familial matter.Thefindings have theoretical and practical implications.We have identified new dimensions of social stigma,social isolation,and domestic violence that are new additions to the existing bank of literature.It provides insights to encourage public authorities,healthcare providers,and NGO managers to play their role in the right direction to mitigate the problem.This study opens further venues for researchers to investigate the complex issue of suicide more deeply.

A Systemic Functional Interpretation of English Expletives at the Ideational and Interpersonal Level

This thesis put the expletives into the whole language system to analyze, using the frame of the Halliday's(1985) System-Functional Linguistics Theory. The expletives can be analyzed on the sentential level, including the ideational function and the interpersonal function.

Suicide ideation, depression and HIV among pregnant women in rural South Africa

Background: Despite public perception to the contrary, pregnancy does not offer a protective effect for suicide ideation. In low and middle income countries (LMIC) multiple concurrent risk factors including unplanned pregnancies, testing for HIV, intimate partner violence and depression may increase suicide risk among pregnant women. We examine suicide ideation among women attending routine antenatal care in rural South Africa. Method: A consecutive series of 109 women in the second half of pregnancy were enrolled in a cross-sectional study at a large primary health care facility in a rural area of KwaZulu-Natal with high HIV prevalence. Using a mixed-methods approach, women were assessed using the Major Depression Section of the Structured Clinical Interview for Depression (SCID) for DSM-IV diagnosis;qualitative interview data were collected on women’s experiences of suicide ideation and plans. Women were assessed two weeks after routine HIV testing as part of Prevention of Mother-to-Child Transmission (PMTCT) screening. Results: Both HIV-positive (49/109) and HIV-negative (60/109) women were assessed. Depression was high (51/109, 46.7%) and equally common amongst HIV-positive and negative women. Suicide ideation was high (30/109, 27.5%) with thoughts of self harm closely linked to suicide plans. Age, previous history of depression and current depression were significantly associated with suicide ideation. Close to equal numbers of HIV-positive and negative women were suicidal. Suicide methods were frequently violent and most women cited family and partnership conflict related to an unplanned pregnancy or their newly HIV-positive status as triggers to their suicide ideation. Conclusions: Rates of suicide ideation among pregnant women testing for HIV are high. Testing HIV-positive causes considerable distress, and among HIV-negative women unplanned and unwanted pregnancies are important risk factors for suicide ideation. Pregnancy brings women into increased contact with the health services with important opportunities for prevention and intervention.

Childhood maltreatment and suicide ideation: A possible mediation of social support

BACKGROUND Existing literature suggests a positive link between childhood maltreatment(CM)and suicide ideation(SI).Nevertheless,whether social support significantly mediates this association remains unknown.AIM To investigate whether social support significantly mediates the association between CM and SI.METHODS In this cross-sectional study of 4732 adolescents from southwest China,we intended to discuss the association between CM and multiple types of SI.In addition,the mediation of major types of social support in this association was also investigated.A self-administrated questionnaire was used to collect the data.A series of multivariate logistic regression models were employed to estimate the association between different types of CM,social support,and SI.The possible mediation of social support in the association between CM and SI was assessed using the path model.RESULTS Based on the cutoffs for subscales of Childhood Trauma Questionnaire,928(19.61%),1269(26.82%),595(12.57%),2337(49.39%),and 3067(64.81%)respondents reported physical abuse,emotional abuse,sexual abuse,physical neglect,and emotional neglect,respectively.Among all the social sources,parental support presented as a significant mediator in the association between emotional maltreatment,both abuse and neglect,and all three types of SI:1-wk,1-year,and lifetime.Parental social support mediated 5.31%and 29.23%,4.80%and 24.50%,and 7.04%and 44.42%of the overall emotional abuse-SI and emotional neglect-SI associations,respectively.CONCLUSION Our findings suggest that improving parental social support might be effective in preventing suicidal risk related to childhood emotional maltreatment in adolescents.

Suicidal Ideation among Depressed People Living with HIV/AIDS in Nigeria, West Africa

Objective: Transient suicide thoughts are common to some people throughout the course of HIV disease and often do not indicate significant risk of suicide. However, persistent suicidal thoughts with associated feelings of hopelessness and intent to die are very serious and must be assessed promptly and carefully. The aim of this study, therefore, was to examine the relationship between depression, hopelessness, psychosocial stressors and suicidal ideation in PLWHAs. Methods: This was a hospital based, cross sectional, descriptive study, of one hundred and seventy depressed adult HIV/AIDS patients of Kwara State Specialist Hospital, Ilorin. Depression and suicidal assessment were evaluated using the PHQ-9 scale. A score of >9 or any affirmative response to question 9 of the PHQ-9 scale necessitated suicidal risk assessment. The social determinant questionnaire was used to evaluate social cohesion and negative life events. Results: The prevalence of depression among the HIV/AID patient was 56.7%. Twenty nine (17.1%) were hopeless, twenty eight (16.5%) had at one time or the other thought of taking their lives, six (3.5%) had plan to take their lives. There was strong statistical association between depression, hopelessness (p-value = 0.000) thought of taking life (p-value = 0.000) and plan to take their lives (p-value = 0.030). Conclusion: The significant correlations between hopelessness, depression and suicidal ideation are important markers that should alert clinicians to underlying suicide risk in HIV-positive patients. In addition, low social cohesion and stressful life events were found to be risk factors for depression and suicide. Clinicians should routinely enquire about suicidality in PLWHAs to assist early diagnosis and intervention.

Treatment priority for suicide ideation and behaviours at an Australian emergency department

AIM: To investigate the treatment priority given to selfharmers presenting to a hospital emergency department(ED) in Queensland, Australia, over the period 2005-2010. METHODS: The main outcome measure of this study was the treatment priority given to persons presenting with suicide ideation and communication(SIC) or self-harming behaviour. Treatment priority was measured using the Australasian Triage Scale, which ranks patients from 1(in need of immediate treatment) to 5(assessment and treatment to start within 120 min). Ordered logistic regression was used to assess the broad demographic and treatment-related factors associated with more urgent triage categories and to in-vestigate which methods of non-fatal suicidal behaviour(NFSB) were prioritised as most urgent.RESULTS: Most cases of NFSB were between 15 and 34 years. A larger proportion of persons presenting for SIC were aged 35 to 44 years. Over 50% of male presentations and 38% of female presentations were for SIC. Those cases prioritised as being more urgent had significantly greater odds of being older, presented after an act of self-harm rather than SIC, and had used multiple methods of NFSB. These individuals also had greater odds of being male and having made past presentations for SIC or NFSB. Among males, those presenting after ingestion of drugs had the greatest odds of receiving immediate attention compared to SIC. "Cutters" were considered as the least "urgent" subjects, and had a greatest risk of waiting 60 to 120 min for treatment compared to suicide ideators. Among females, those presenting with chemicals, poisons and gases had the greatest odds of receiving immediate attention compared to SIC. Females who presenting after cutting themselves had lower odds of receiving immediate treatment than those who presented with SIC. CONCLUSION: ED staff seems to judge the urgency of cases based on demographic factors such as age and gender, as well as method of NFSB.

Non-Violent Communication and Its Impact on Suicidal Ideations and Coping with Stress Styles

One of the important dimensions of violence is suicide, or violence directed toward self that many people suffer from nowadays. In the meantime, adolescents and especially girls are more likely to be harmed. The purpose of this study was to evaluate the effect of group training with non-violent communication (NVC) method on suicidal ideations and coping with stress styles of adolescent girls. The target community in this research was availably selected from the charity centers of Tehran suburbs. In this study, 15 adolescent girls were in the experimental group and 15 in the control group. The criteria for entering the research were students aged 11 to 19 years and the vulnerable socio-economic income. Eight training sessions of NVC were presented for the experimental group in the pre-test and post-test intervals, while no intervention was performed for the control group. Data collection instruments were Beck’s scale for suicidal ideation (BDI) and Endler & Parker’s coping inventory for stressful situations (CISS). After statistical analysis, the effectiveness of this training was investigated on dependent variables by multivariate analysis of covariance. Eventually, the results showed a significant difference between the experimental and control groups (p < 0.05). The finding of the study showed that NVC training can reduce suicidal ideations in adolescent girls who are socially and economically vulnerable. According to the findings, non-violent communication training has a higher effect on emotion-focused coping style compared to other stress coping styles.

Variables associated with suicide ideation and plans in a Japanese population

The purpose of our study was to clarify variables associated with suicide ideation and plans in a Japanese population. We conducted a random-sampling survey on mental health and suicide using a self-administered questionnaire for Hamamatsu City residents aged 15-79 yrs between May and June, 2008. This included questions about gender, age, outpatient treatment, alcohol problems, depression, living ar-rangements, marital status, annual family income, industry types as well as suicide ideation and plans. The correlation between these variables and suicide ideation or plans was then analyzed with multiple logistic regression analysis by gender. A total of 1051 responded to this questionnaire (response rate, 53.9%). Variables statistically associated with suicide ideation in males included alcohol problems, depression, lower annual family income, and ac-commodations/eating/drinking services, while in females, the variables were younger age, outpatient treatment, depression, living alone, being single, being separated, lower annual family income, accommodations/eating/drinking services and unemployment. On the other hand, variables statistically associated with suicide plans in males were younger age, alcohol problems, depression, and lower annual family income, while in females they were younger age, alcohol problems, depression, being separated, lower annual family income, manufacturing, and accommodations/eating/drinking services. Ex-cept for industry types, variables associated with suicide ideation or plans were consistent with previous studies. The reason why workers engaging in manufacturing, or accommoda-tions/eating/drinking services were more likely to have suicide ideation or plans may be attributed to the structures and/or stresses unique to those industries.

Self-Efficacy as a Suicidal Ideation Predictor: A Population Cohort Study in Rural Japan

Background: Self-efficacy has been widely studied in suicide, both in its causality and treatment effects. However, the evidence of causality is still ambiguous and there is a lack of generalizability. The aim of this study was to examine the relationship between self-efficacy and suicidal ideation through a population cohort study. Methods: The community-based household survey using a self-administered questionnaire was conducted in a rural area of Japan, Happo Town, in Akita Prefecture with community residents aged 30 and over at two respective time points by local health volunteers. The baseline survey was conducted in 2010 with a response rate of 88.9% (n = 6044). Among them, 3812 residents met the inclusion criteria for the follow-up survey in 2012 where the response rate was 75.3% (n = 2869). Exposure variables to suicidal ideation included demographic details, depression and self-efficacy. The Institutional Review Board and the Ethics Committee of Akita University approved the study protocol and all subjects signed informed consent. Results: A total number of 2105 participants (76.4%) without suicidal ideation in the baseline study were enrolled into the follow-up study, and 8.2% of them had developed suicidal ideation. These participants with suicidal ideation were significantly less likely to be married/cohabitant;they had worse subjective health, poorer self-perceived economic status, stronger depressive mood, and lower self-efficacy scores. The odds ratio of the self-efficacy scores at follow-up survey for participants who had developed suicidal ideation were about 2 times lower than at baseline (95% confidence interval = 1. 53 - 3.06). After adjusting for all confounding factors, the association was still significant (OR = 1.66, 95% CI = 1.15 - 2.42). Conclusion: This result suggests that suicidal ideation may be prevented by increasing self-efficacy. We suggest that self-efficacy can be an effective tool for identifying people with suicidal ideation, and increasing self-efficacy can be strategically beneficial for larger suicide prevention.

Proposed Scales for Measuring Suicidal Ideation in Adult Cancer Patients

Suicidal ideation, which can occur in oncology patients, is associated with suffering and a reduced quality of life. Empirical studies indicate that the incidence of suicide in people with cancer is approximately twice that of the general population. Objective: This cross-sectional descriptive study was designed to establish the prevalence of suicidal ideation in adult oncology patients based on a combination of scales to measure this variable. Method: A battery of three instruments (Scale for Suicidal Ideation. Item 9 of Beck’s Depression Inventory, and a semi-structured interview) was used to make estimates that are not based on just one test and can thus make a comprehensive evaluation of suicidal ideation in the study sample. Four approximations, based on different items from suicidal ideation assessment scales, were developed to determine the most sensitive combination for identifying the presence of suicidal ideation in adult cancer patients. Results: The highest prevalence of suicidal ideation found with the proposed scales was 24.5% (CI = 16%-33%) with Scale 1;23.6% (CI = 15.2%-32%) with Scale 2;and 19.1% (CI = 11.3%-26.9%) with Scale 4. The lowest prevalence of suicidal ideation was 17.3% (CI = 9.8%-24.8%) with Scale 3. Conclusions: Suicidal behavior in the oncology patient should be assessed;however, there is a need to select sensitive instruments that can be applied easily and are suitable for the target group, which faces difficulties in participating in extensive evaluations.

Suicidal Ideation and Attempts during Middle Childhood: Associations with Subjective Quality of Life and Depression

Background: Confronted to the increasing suicide rate in children, clinicians have to better understand and predict suicide-related behaviours (SRBs) in children with and without depressive symptoms. Aims: To investigate associations among suicidal tendencies (thoughts and/or attempts), depression and children’s perceptions of subjective quality of life. Methods: This was a cross-sectional study of 157 children of 6 - 13-year-old. Results: Children who attempted or thought of suicide reported goodless subjective quality of life than nonsuicidal children did, and children who thought of or attempted suicide reported higher levels of depressive symptoms than nonsuicidal children. Limitations: A more rigorous approach to investigating suicidal ideation and depressive symptomatology as a diagnostic interview based on the DSM-IV-TR will be valuable to future progress in understanding children’s suicidality. Conclusions: Results may reflect the confirmation of depressive symptoms as risk factors for suicidality and underline the high importance of social and emotional life context among suicidal children. For this reason, more effective recognition and comprehension of the underlying affective and social conditions of children with suicidality have special importance to prevent future suicidal behaviour during adolescence.

Effects of Stress, Depression, and Problem Drinking on Suicidal Ideation among Korean Workers

The mental health of workers is an important issue that affects not only individuals and their families but also workplaces and communities.Therefore,it is necessary to regularly evaluate and analyze workers’mental health status,including levels of stress,depression,and addictive behaviors to apply thesefindings in creating mental health promotion programs.This study aims to provide basic data that would facilitate early intervention for workers’mental health problems by analyzing factors such as stress,depression,and problem drinking that can affect suicidal ideation.From April 15 to October 25,2019,a survey was conducted with 165 workers across six workplaces in a Korean city.Analysis was performed using descriptive statistics,correlation,and simple and multiple regression analyses using the R statistics program 4.0.3.There was no difference in suicidal ideation scores based on the participants’general characteristics,while there was a significant positive correlation among stress,depression,problem drinking,and suicidal ideation.In addition,severe depression,severe stress,and severe problem drinking had significant effects on suicidal ideation,and among the subitems of stress,somatic symptoms had an effect on suicidal ideation.In addition,severe stress,somatic symptoms,depression,and severe problem drinking had a significant effect on suicidal ideation in males but not in females.It is necessary to identify the effects of stress,depression,drinking problems,and suicide on workers’mental health,and evaluate their mental health systemati-cally and regularly to recognize whether active psychiatric treatment and nursing intervention are necessary as well as preventive management.In addition,it is meaningful to pay attention to the suicide ideation of adult workers and provide basic data to promote systematic public health policies on mental health.

A Systemic-functional Approach to Ideational Metaphor in English Nursery Rhymes

Ideational metaphor is a typical type of grammatical metaphor. The analysis of grammatical metaphor in English nursery rhymes from the perspective of ideational metaphor, which tries to explore possible evidence of the existence of ideational metaphor in the language of young children-nursery rhymes. Children learn probably many equally complex systems as that of human language.

抑郁症患者自杀观念与血清炎症因子和代谢指标的相关性

目的:探索抑郁症患者自杀观念与血清代谢指标及炎症因子的相关性。方法:纳入2020年5月至2022年8月在我院精神心理科住院的首发抑郁症患者119例,根据汉密尔顿抑郁量表(Hamil-ton depression scale,HAMD)条目3“自杀”(H3)的评分进行分组,H3≥1分为有自杀观念组(74例),H3<1分为无自杀观念组(45例)。比较两组血清中代谢指标和炎症因子差异。采用相关性分析的方法分析抑郁症患者自杀观念与血清中代谢指标和炎症因子的相关性。结果:两组的炎症因子和代谢指标差异均有统计学意义,伴有自杀观念组患者血清中白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)水平均较无自杀观念组高(P均<0.05),代谢指标的比较发现有自杀观念组的肌酐水平低于无自杀观念组(P<0.05);相关分析发现IL-2(r=0.29,P<0.01)、IL-4(r=0.20,P=0.03)和IL-17(r=0.21,P=0.02)水平与H3的评分呈正相关,肌酐水平与H3的评分呈负相关(r=-0.22,P=0.02)。结论:伴有自杀观念的抑郁症患者肌酐代谢和血清炎症因子与无自杀观念者存在差异,且与自杀风险存在一定关联。

知觉压力与大学生自杀意念:心理复原力和抑郁的链式中介作用

目的探讨知觉压力与自杀意念的关系,并探究心理复原力和抑郁在其中的中介作用。方法采用知觉压力量表、大学生复原力量表、贝克抑郁量表和自杀意念量表对875名大学生进行调查。结果①知觉压力与抑郁、自杀意念呈显著正相关,与心理复原力呈显著负相关;②知觉压力不能直接影响大学生自杀意念,但能通过3条间接路径对自杀意念产生影响:心理复原力的单独中介作用、抑郁的单独中介作用以及心理复原力和抑郁的链式中介作用。结论心理复原力和抑郁在知觉压力与大学生自杀意念的关系中间起链式中介作用。

艾司氯胺酮丙泊酚复合麻醉下电休克治疗伴有自杀意念重度抑郁障碍患者的效果分析

目的比较通过不同剂量艾司氯胺酮联合电休克治疗伴有自杀意念重度抑郁障碍患者的效果,分析艾司氯胺酮作为具有抗抑郁作用特点的电休克麻醉剂,针对伴有自杀意念的重度抑郁障碍患者治疗时的优点和不足,为艾司氯胺酮在临床工作中更好地应用提供参考。方法120名患者通过随机数字表法分为对照组、低剂量组和高剂量组,每组各40例(n=40)。对照组予以丙泊酚1.2~1.5 mg/kg缓慢推注麻醉,低剂量组予以0.3 mg/kg艾司氯胺酮加1.0 mg/kg丙泊酚缓慢推注麻醉,高剂量组予以0.6 mg/kg艾司氯胺酮加0.5~0.8 mg/kg丙泊酚缓慢推注麻醉,后行无抽搐电休克治疗(MECT),治疗过程中评价疗效、安全性指标和对认知功能的影响。结果对照组、低剂量组和高剂量组患者的HAMD-24评分治疗前无明显差异,经MECT治疗后评分值逐组递减,低剂量组、高剂量组各项观察指标较对照组有差异(均P<0.05),低剂量组与高剂量组各项观察指标有差异(均P<0.05);重复性成套神经心理状态测验(RBANS)对三组患者行认知功能评估,结果显示三组患者治疗后高剂量组的RBANS评分分值明显高于低剂量组、对照组(均P<0.05);三组120例患者中没有出现严重的不良反应,三组不良反应发生率相比较,差异均无统计学意义(P>0.05);利用Beck自杀意念量表对三组患者接受治疗后自杀意念的疗效进行评估,结果显示治疗后高剂量组的Beck自杀意念量表评分分值明显低于低剂量组、对照组(均P<0.05)。结论三组患者的重度抑郁症状及自杀意念均得到改善,使用不同麻醉剂及不同剂量对伴有自杀意念的重度抑郁患者疗效随着剂量的变化呈现显著差异,且均未出现严重的不良反应,其应用到临床的安全性已得到验证,值得临床进一步推广。