Department of Psychology, Mississippi State University, P.O. Box 6161, Starkville, MS 39762, USA.
Department of Psychology, Mississippi State University, P.O. Box 6161, Starkville, MS 39762, USA.
Psychiatry Res. 2014 Aug 15;218(1-2):124-8. doi: 10.1016/j.psychres.2014.04.016. Epub 2014 Apr 16.
This study examined the relationship among symptoms of anhedonia and suicidal ideation at baseline, at termination, and over time in 1529 adult psychiatric inpatients. Anhedonia was associated with suicidality cross-sectionally at baseline and at termination. In addition, change in anhedonia from baseline to termination predicted change in suicidality from baseline to termination, as well as level of suicidality at termination; moreover, anhedonia remained a robust predictor of suicidal ideation independent of cognitive/affective symptoms of depression. Symptom-level analyses also revealed that, even after accounting for the physical aspect of anhedonia (e.g., loss of energy), loss of interest and loss of pleasure were independently associated with higher levels of suicidal ideation at baseline, over time, and at discharge. Loss of interest was most highly predictive of suicidal ideation, providing support for recent differential conceptualizations of anhedonia. Taken together, these findings indicate that the manner in which anhedonia is conceptualized is important in predicting suicidal ideation, and that anhedonia symptoms warrant particular clinical attention in the treatment of suicidal patients.
这项研究调查了 1529 名成年精神科住院患者在基线、治疗结束时和随访期间的快感缺失症状与自杀意念之间的关系。快感缺失与基线和治疗结束时的自杀意念呈横断面相关。此外，从基线到治疗结束时快感缺失的变化预测了从基线到治疗结束时自杀意念的变化，以及治疗结束时自杀意念的水平；此外，快感缺失仍然是抑郁的认知/情感症状之外预测自杀意念的有力指标。症状水平分析还表明，即使在考虑了快感缺失的身体方面（例如，精力丧失）之后，兴趣丧失和快感丧失仍与基线时、随时间推移时以及出院时更高水平的自杀意念独立相关。兴趣丧失最能预测自杀意念，为快感缺失的最新差异化概念化提供了支持。综上所述，这些发现表明，快感缺失的概念化方式对预测自杀意念很重要，快感缺失症状在治疗自杀患者时需要特别关注。
