赵嘉玮,刘伟,王道金.青少年抑郁发作患者自杀行为态度及其相关因素[J].四川精神卫生杂志,2023,36(3):209-215.Zhao Jiawei,Liu Wei,Wang Daojin,Attitudes towards suicidal behavior and related factors in adolescent patients with depressive episode[J].SICHUAN MENTAL HEALTH,2023,36(3):209-215
青少年抑郁发作患者自杀行为态度及其相关因素
Attitudes towards suicidal behavior and related factors in adolescent patients with depressive episode
投稿时间:2023-02-27  
DOI:10.11886/scjsws20230227001
中文关键词:  青少年  自杀行为态度  抑郁发作  父母教养方式  网络成瘾
英文关键词:Adolescents  Attitude towards suicidal behaviors  Depression episode  Parenting styles  Internet addiction
基金项目:2021年度芜湖市卫生健康委科研项目(项目名称:青少年抑郁障碍伴自杀行为相关因素研究,项目编号:WHWJ2021y076);蚌埠医学院研究生科技创新项目(项目名称:青少年抑郁障碍患者自杀意念与家庭教养及网络成瘾相关研究,项目编号:Byycxz21040)
作者单位邮编
赵嘉玮 蚌埠医学院研究生院安徽 蚌埠 233030 233030
刘伟* 芜湖市第四人民医院安徽 芜湖 241002 241002
王道金 芜湖市第四人民医院安徽 芜湖 241002
蚌埠医学院精神卫生临床学院安徽
蚌埠 233030 
233030
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中文摘要:
      背景 青少年人群对自杀的态度与其自杀行为高度相关,既往关于自杀态度及其相关因素的研究多聚焦于学校样本,对青少年抑郁发作患者相关临床样本的研究不足。目的 分析青少年抑郁发作患者对自杀行为的态度及相关因素,为这一群体的自杀干预提供参考。方法 连续选取2021年5月-2022年7月芜湖市第四人民医院门诊及住院部符合《国际疾病分类(第10版)》(ICD-10)抑郁发作诊断标准的青少年患者共100例。采用自编一般情况调查问卷收集患者人口学资料,采用汉密尔顿抑郁量表17项版(HAMD-17)、自杀态度问卷(QSA)、父母教养方式评价量表(EMBU)以及网络成瘾量表(IAT)分别评定患者的抑郁症状、自杀态度、父母教养方式和网络成瘾情况。采用Spearman和Pearson相关分析探讨患者QSA中对自杀行为的态度因子评分与一般情况和HAMD-17评分、EMBU评分及IAT评分的相关性。采用多元线性回归分析考查自杀行为的态度的危险因素,绘制ROC曲线评估各因素预测对自杀行为的态度的有效性。结果 青少年抑郁发作患者QSA对自杀行为的态度因子评分与对自杀者的态度因子、对安乐死的态度因子、母亲情感温暖与理解因子评分均呈正相关(r=0.210~0.485,P<0.05或0.01),与父亲受教育程度、近6个月自杀行为、HAMD-17评分、IAT评分、父亲惩罚与严厉、父亲过分干涉、父亲拒绝与否认、父亲过度保护、母亲过分干涉与保护、母亲拒绝与否认、母亲惩罚与严厉因子评分均呈负相关(r=-0.571~-0.290,P<0.05或0.01)。多元线性回归分析显示,QSA对自杀者的态度因子(β=0.198,P<0.01)和对安乐死的态度因子(β=0.302,P<0.01)可正向预测对自杀行为的态度,父亲受教育程度(β=-0.180,P=0.043)、HAMD-17评分(β=-0.366,P<0.01)以及IAT评分(β=-0.191,P=0.030)可负向预测对自杀行为的态度。各因素之间预测效能比较差异均无统计学意义(Z=-1.289~0.092,P均>0.05)。结论 网络成瘾、抑郁严重程度、对自杀者的态度、对安乐死的态度和父亲受教育程度可能影响青少年抑郁发作患者对自杀行为的态度。
英文摘要:
      Background Attitude towards suicide among adolescents is closely linked with their suicidal behavior. Previous studies on suicidal attitudes and related factors primarily focused on school samples, with limited research on relevant clinical samples of adolescents with depressive episode.Objective To analyze the attitudes towards suicidal behavior and the influencing factors in adolescent patients with depressive episode, so as to provide references for suicide intervention in this population.Methods A total of 100 adolescent patients who met the diagnostic criteria for depressive episode according to the International Classification of Diseases, tenth edition (ICD-10) were selected from the outpatient and inpatient departments of the Fourth People's Hospital of Wuhu from May 2021 to July 2022. A self-designed general demographic questionnaire, Hamilton Depression Scale-17 item (HAMD-17), Suicide Attitude Questionnaire (QSA), Egma Minnen av Bardndosnauppforstran (EMBU) and Internet Addiction Test (IAT) were used to evaluate the patients' depressive symptoms, attitudes towards suicide, parenting styles and Internet addiction, respectively. Spearman and Pearson correlation analyses were used to examine the correlation between the factor scores of attitudes towards suicidal behavior in QSA and demographic characteristics, HAMD-17 score, EMBU score and IAT score. Multiple linear regression was conducted to screen the risk factors associated with attitudes towards suicidal behavior, and ROC curves were plotted to evaluate the predictive efficacy of each factor.Results The scores on attitudes towards suicidal behavior in QSA among adolescent patients with depressive episode were positively correlated with scores on attitude towards the suicidal person, attitude towards euthanasia, as well as scores on mother's emotional warmth and understanding factor (r=0.210~0.485, P<0.05 or 0.01). Conversely, they were negatively correlated with father's education level, suicidal behavior in the past 6 months, HAMD-17 score, IAT score, father's punishment and harshness, father's overinvolved, father's rejection and denial, father's overprotection, mother's overinvolved and overprotection, mother's rejection and denial, and mother's punishment and harshness factor scores (r=-0.571~-0.290, P<0.05 or 0.01). Multiple linear regression analysis revealed that QSA scores on attitude towards the suicidal person (β=0.198, P<0.01) and attitude towards euthanasia (β=0.302, P<0.01) positively predicted score on attitude towards suicidal behavior, and fathers' education level (β=-0.180, P=0.043), HAMD-17 scores (β=-0.366, P<0.01) and IAT scores (β=-0.191, P=0.030) negatively predicted scores on attitude towards suicidal behavior. The differences in predictive efficacy between the factors were not statistically significant (Z=-1.289~0.092, P>0.05).Conclusion Internet addiction, depression severity, attitudes towards suicide, attitudes towards euthanasia and father's education level may influence attitudes towards suicidal behavior in adolescent patients with depressive episode. [Funded by Scientific Research Project of Wuhu Municipal Health Commission in 2021 (number, WHWJ2021y076), Bengbu Medical College Postgraduate Science and Technology Innovation Project (number, Byycxz21040)]
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