Straub Joana, Keller Ferdinand, Sproeber Nina, Koelch Michael G, Plener Paul L
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, <location>Ulm, Germany</location>
Z Kinder Jugendpsychiatr Psychother. 2015 Jan;43(1):39-45. doi: 10.1024/1422-4917/a000331.
Research in adults has identified an association between bipolar disorder and suicidal behavior. This relationship, however, has been insufficiently investigated in adolescents to date.
1,117 adolescents from 13 German schools (mean age = 14.83, SD = .63; 52.7% females) completed an extended German version of the Center for Epidemiological Studies Depression Scale (CES-D), which assesses depressive and manic symptoms during the last week, as well as the Self-Harm Behavior Questionnaire (SHBQ) for the assessment of lifetime suicidal behavior.
In the present sample 39.4% of the girls and 23.1% of the boys reported lifetime suicidal thoughts and 7.1% of the girls as well as 3.9% of the boys a lifetime history of suicide attempts. 18.7% of the adolescent sample revealed elevated symptoms of depression and 9% elevated levels of mania symptoms. Elevated sum scores of depression and mania were associated with a higher number of suicidal ideations and suicide attempts. A block-wise regression analysis revealed that sum scores of depression and mania predicted suicidal ideations best. Concerning suicide attempts, the best predictors were age as well as depression and mania sum scores.
Suicidal behavior was reported more often when adolescents demonstrate symptoms of mania as well as symptoms of depression than when they demonstrate only depressive symptoms. The presence of bipolar symptoms in adolescents should alert clinicians to the heightened possibility of suicidal behavior.
针对成年人的研究已确定双相情感障碍与自杀行为之间存在关联。然而，迄今为止，这种关系在青少年中尚未得到充分研究。
来自13所德国学校的1117名青少年（平均年龄 = 14.83，标准差 = 0.63；52.7%为女性）完成了一份扩展的德文版流行病学研究中心抑郁量表（CES-D），该量表评估过去一周的抑郁和躁狂症状，以及用于评估终生自杀行为的自我伤害行为问卷（SHBQ）。
在本样本中，39.4%的女孩和23.1%的男孩报告有终生自杀念头，7.1%的女孩以及3.9%的男孩有终生自杀未遂史。18.7%的青少年样本显示抑郁症状升高，9%的样本显示躁狂症状水平升高。抑郁和躁狂的总分升高与更多的自杀意念和自杀未遂相关。逐步回归分析显示，抑郁和躁狂的总分对自杀意念的预测效果最佳。关于自杀未遂，最佳预测因素是年龄以及抑郁和躁狂的总分。
与仅表现出抑郁症状的青少年相比，当青少年同时表现出躁狂症状和抑郁症状时，报告的自杀行为更为常见。青少年出现双相症状应提醒临床医生注意自杀行为可能性增加。
