摘要
目的研究双相Ⅰ型与双相Ⅱ型抑郁障碍患者自伤自杀的特点。方法97例住院双相抑郁障碍患者,其中双相Ⅰ型43例(44.33%),双相Ⅱ型54例(55.67%);对患者自伤的频度、自伤的方式、自杀意念、自杀次数、自杀方式进行问卷评定;采用汉密尔顿抑郁量表-17、汉密尔顿焦虑量表、32项轻躁狂症状清单评定患者的临床症状,用DSM-Ⅳ-TR轴Ⅱ障碍临床定式检查边缘性人格障碍的诊断条目进行评定。结果双相Ⅱ型抑郁障碍患者自伤自杀意念和行为发生率为77.78%,高于双相Ⅰ型患者的39.54%(χ ^(2)=14.693,P<0.01)。双相Ⅱ型抑郁障碍患者自伤行为发生率为64.82%,高于双相Ⅰ型患者的23.26%(χ ^(2)=18.093,P<0.01)。双相Ⅱ型抑郁障碍患者自杀次数为1(0,1.25)次,高于双相Ⅰ型患者的0(0,1)次(Z=2.289,P=0.022)。双相Ⅱ型抑郁障碍患者用刀和利器割刺自己、抠或抓自己、用力拔扯自己的头发、用力咬自己等发生率高于双相Ⅰ型患者(P<0.05);在自杀方式上双相Ⅱ型抑郁障碍患者过量服用治疗药物、跳落更突出(P<0.05)。双相Ⅱ型抑郁障碍患者伴边缘性人格占62.96%,高于双相Ⅰ型患者的18.60%(χ ^(2)=19.185,P<0.01)。结论双相Ⅱ型抑郁障碍患者自伤自杀的发生率较双相Ⅰ型患者更高,自伤自杀方式与双相Ⅰ型患者明显不同,伴边缘性人格及自伤自杀问题突出。
Objective To study the characteristics and related factors of self-injury and suicide in bipolarⅠand bipolarⅡdepression.Methods 97 hospitalized patients with bipolar depression met the diagnostic criteria of DSM-5 bipolar disorder as major depressive episode were selected,including 43 cases of bipolarⅠtype(44.33%)and 54 cases of bipolarⅡtype(55.67%).The frequency of self-injury,ways of self-injury,suicidal ideation,times of suicide and ways of suicide were evaluated by questionnaire.The clinical symptoms of the patients were assessed using the Hamilton Depression Scale-17,Hamilton Anxiety Scale and 32-item Hypomania Checklist.The diagnosis items of borderline personality disorder in the DSM-Ⅳ-TR AxisⅡDisorder Clinical Standard Examination were assessed.Results 77.78%of bipolarⅡpatients had significantly higher rate of self-injury and suicide than 39.54%of bipolar I patients(χ^(2)=14.693,P<0.01).The proportion of bipolarⅡtype with self-injury was 64.82%,which was significantly higher than that of bipolar I type(23.26%)(χ^(2)=18.093,P<0.01).The suicide frequency of bipolarⅡdepression patients was 1(0,1.25)times,which was significantly higher than that of bipolar I depression patients 0(0,1)times(Z=2.289,P=0.022).The ways of self-injury in bipolarⅡdepression patients were significantly higher than those in bipolar I depression patients in⑴cutting themselves with knives and sharp tools,⑵picking or scratching themselves,pulling their hair forcibly,⑶biting themselves forcibly(P<0.05).Patients with bipolarⅡdepression were more likely to commit suicide by taking medication and jumping off(P<0.05).Borderline personality was higher in bipolarⅡ(62.96%)than bipolarⅠ(18.60%)(χ^(2)=19.185,P<0.01).Conclusion The incidence of self-injury and suicide in bipolarⅡdepression patients is higher than that in bipolar I depression patients.The way of self-injury and suicide is obviously different between them.The problem of self-injury and suicide in patients with borderline personality is prominent.
作者
崔利军
杨永涛
刘俞董
韩紫非
郭艳梅
CUI Lijun;YANG Yongtao;LIU Yudong;HAN Zifei;GUO Yanmei(Department of Psychiatry,Hebei Mental Health Center,Baoding 071000,China;Department of Psychiatic,Zhuhai Center for Chronic Disease Control,Zhuhai 519000,China)
出处
《医学研究与教育》
CAS
2023年第2期10-17,共8页
Medical Research and Education
基金
河北省财政厅、河北省卫生健康委政府资助临床医学优秀人才项目(361014)。
关键词
双相障碍
自伤
自杀
边缘性人格障碍
汉密尔顿抑郁量表
bipolar disorder
self-injury
suicide
borderline personality disorder
Hamilton Depression Scale
