Witte Tracy K, Timmons Katherine A, Fink Erin, Smith April R, Joiner Thomas E
Florida State University, Department of Psychology, 32306-4301, United States.
J Affect Disord. 2009 May;115(1-2):69-78. doi: 10.1016/j.jad.2008.09.003. Epub 2008 Oct 8.
Although there has been a tremendous amount of research examining the risk conferred for suicide by depression in general, relatively little research examines the risk conferred by specific forms of depressive illness (e.g., dysthymic disorder, single episode versus recurrent major depressive disorder [MDD]). The purpose of the current study was to examine differences in suicidal ideation, clinician-rated suicide risk, suicide attempts, and family history of suicide in a sample of outpatients diagnosed with various forms of depressive illness.
To accomplish this aim, we conducted a cluster analysis using the aforementioned suicide-related variables in a sample of 494 outpatients seen between January 2001 and July 2007 at the Florida State University Psychology Clinic. Patients were diagnosed using DSM-IV criteria.
Two distinct clusters emerged that were indicative of lower and higher risk for suicide. After controlling for the number of comorbid Axis I and Axis II diagnoses, the only depressive illness that significantly predicted cluster membership was recurrent MDD, which tripled an individual's likelihood of being assigned to the higher risk cluster.
The use of a cross-sectional design; the relatively low suicide risk in our sample; the relatively small number of individuals with double depression.
Our results demonstrate the importance of both chronicity and severity of depression in terms of predicting increased suicide risk. Among the various forms of depressive illness examined, only recurrent MDD appeared to confer greater risk for suicide.
尽管已有大量研究探讨了一般抑郁症所带来的自杀风险,但相对较少的研究考察了特定形式的抑郁性疾病(如恶劣心境障碍、单次发作与复发性重度抑郁症[MDD])所带来的风险。本研究的目的是在一组被诊断患有各种形式抑郁性疾病的门诊患者样本中,考察自杀意念、临床医生评定的自杀风险、自杀未遂及自杀家族史方面的差异。
为实现这一目标,我们对2001年1月至2007年7月间在佛罗里达州立大学心理诊所就诊的494名门诊患者样本,使用上述与自杀相关的变量进行了聚类分析。患者依据《精神疾病诊断与统计手册》第四版标准进行诊断。
出现了两个不同的聚类,分别表明自杀风险较低和较高。在控制了共病的轴I和轴II诊断数量后,唯一能显著预测聚类归属的抑郁性疾病是复发性MDD,它使个体被分配到高风险聚类的可能性增加了两倍。
采用横断面设计;我们样本中的自杀风险相对较低;双相抑郁症患者数量相对较少。
我们的结果表明,抑郁症的慢性病程和严重程度在预测自杀风险增加方面都很重要。在所考察的各种形式的抑郁性疾病中,只有复发性MDD似乎会带来更高的自杀风险。