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双相情感障碍-抑郁焦虑气质模式与 346 例主要心境障碍患者的自杀风险有关。

Cyclothymic-depressive-anxious temperament pattern is related to suicide risk in 346 patients with major mood disorders.

机构信息

Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

出版信息

J Affect Disord. 2012 Feb;136(3):405-11. doi: 10.1016/j.jad.2011.11.011. Epub 2011 Dec 16.

Abstract

BACKGROUND

Suicidal behavior is one of the most alarming signs not only in psychiatry, and current major depressive episode is the most frequent medical condition among suicide victims and attempters. The aim of the study was to investigate the relationship between the individual pattern of affective temperaments, non-typical symptoms of depression as measured with the Gotland Scale for Male Depression (GSMD), hopelessness and suicidal behavior in major mood disorder patients.

METHODS

Participants were 346 adult inpatients (151 men and 195 women) with major mood disorders consecutively admitted to the Department of Psychiatry of the Sant'Andrea University Hospital in Rome, Italy. All the patients were administered the TEMPS-A, the GSMD, and the Beck Hopelessness Scale (BHS) and the Mini International Neuropsychiatric Interview (MINI).

RESULTS

A Two Step Cluster Analysis procedure, performed to reveal natural groupings within patients' response set, indicated that there were 2-groups: a cyclothymic-depressive-anxious group and a hyperthymic group. More than 81% of the patients with prevailing cyclothymic-depressive-anxious temperament had mild to severe suicidal risk on the MINI vs. only around 42% of the patients with prevailing hyperthymic temperament. Sixty-four percent of patients with prevailing cyclothymic-depressive-anxious temperament had BHS scores of 9 or higher versus only 13% of patients with prevailing hyperthymic temperament. Also, patients with prevailing cyclothymic-depressive-anxious temperament more likely had higher GSMD than patients with prevailing hyperthymic temperament.

LIMITATIONS

The correlational nature of the study limits causal conclusions to be drawn.

CONCLUSIONS

Our results indicate that affective temperament measure along with Gotland Scale for Male Depression could be useful tools in screening and identifying those affective disorder patients who are at higher risk of suicidal behavior.

摘要

背景

自杀行为不仅是精神病学中最令人担忧的迹象之一,目前的主要抑郁发作是自杀受害者和企图自杀者中最常见的医疗状况。本研究的目的是调查个体情感气质模式、使用哥特兰男性抑郁量表(GSMD)测量的非典型抑郁症状、绝望感与重度心境障碍患者自杀行为之间的关系。

方法

参与者为意大利罗马圣安德烈亚大学医院精神病科连续收治的 346 名成年重度心境障碍患者(151 名男性和 195 名女性)。所有患者均接受 TEMPS-A、GSMD、贝克绝望量表(BHS)和迷你国际神经精神访谈(MINI)评估。

结果

两步聚类分析程序揭示了患者反应集中的自然分组,结果表明存在 2 个组:环性抑郁焦虑组和高反应性组。具有主导环性抑郁焦虑气质的患者中,超过 81%的患者在 MINI 上有轻度至重度自杀风险,而具有主导高反应性气质的患者中只有约 42%。具有主导环性抑郁焦虑气质的患者中有 64%的 BHS 评分在 9 分或以上,而具有主导高反应性气质的患者中只有 13%。此外,具有主导环性抑郁焦虑气质的患者比具有主导高反应性气质的患者更有可能具有更高的 GSMD。

局限性

研究的相关性限制了得出因果结论的能力。

结论

我们的研究结果表明,情感气质测量以及哥特兰男性抑郁量表可以作为筛查和识别那些自杀风险较高的情感障碍患者的有用工具。

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