Karam Elie G, Itani Lynn, Fayyad John, Hantouche Elie, Karam Aimee, Mneimneh Zeina, Akiskal Hagop, Rihmer Zoltán
Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry & Clinical Psychology, Saint George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon.
Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon.
J Affect Disord. 2015 Sep 15;184:123-8. doi: 10.1016/j.jad.2015.05.047. Epub 2015 Jun 2.
Several studies have shown temperament variants in suicidality. Yet, to our knowledge, the association between temperaments and suicide attempts has not been studied on a nationally representative level nor systematically in subjects with no mental disorders. Also, although hyperthymic temperament is recognized as protective of most mental disorders, its role in the protection from self-harm remains inconclusive.
The study is based on nationally representative data of all Lebanese adults. Mental disorders were assessed using the Composite International Diagnostic Interview, whereas the five affective temperaments were assessed using the TEMPS-A.
Anxious temperament is a solid and strong risk factor for suicide attempts in subjects with (OR: 10.1) and without (OR: 9.0) mental disorders. Depressive (OR: 4.3) and irritable (OR: 5.1) temperaments are risk factors for suicide attempt among subjects with mental disorders. Hyperthymic temperament plays a dual role in females with mental disorders: while the hyperthymic trait "having self-confidence" is strongly protective of suicide attempts, "liking to be the boss", "getting into heated arguments", and "the right and privilege to do as I please" are hyperthymic risk traits for suicide attempts reflecting the "dark side" of the hyperthymic temperament. Interestingly, these three hyperthymic risk traits--in the absence of "having self-confidence"--are a universal risk for suicide attempt in females with mental disorder.
Social desirability could have led to the under-reporting of suicide attempts and mental disorders.
The anxious temperament plays a strong role in predicting suicide attempts in the community, in the presence and absence of diagnosable mental disorders. The irritable and the depressive temperaments are additional risks in subjects with mental disorders. The dual role of the hyperthymic temperament is quite interesting: while it is protective of suicidal behavior, it also has a dark side in subjects with mental disorders.
多项研究表明自杀倾向存在气质差异。然而，据我们所知，气质与自杀未遂之间的关联尚未在全国代表性层面进行研究，也未在无精神障碍的受试者中进行系统研究。此外，尽管环性气质被认为对大多数精神障碍具有保护作用，但其在预防自我伤害方面的作用仍不明确。
本研究基于黎巴嫩所有成年人的全国代表性数据。使用复合国际诊断访谈评估精神障碍，而使用TEMPS-A评估五种情感气质。
焦虑气质是有精神障碍（比值比：10.1）和无精神障碍（比值比：9.0）的受试者自杀未遂的坚实且强大的风险因素。抑郁（比值比：4.3）和易怒（比值比：5.1）气质是有精神障碍的受试者自杀未遂的风险因素。环性气质在患有精神障碍的女性中发挥双重作用：虽然“有自信”这一环性特质对自杀未遂有很强的保护作用，但“喜欢当老板”“卷入激烈争论”以及“随心所欲行事的权利”是自杀未遂的环性风险特质，反映了环性气质的“阴暗面”。有趣的是，在没有“有自信”的情况下，这三个环性风险特质是患有精神障碍的女性自杀未遂的普遍风险因素。
社会期望可能导致自杀未遂和精神障碍的报告不足。
焦虑气质在预测社区中是否存在可诊断精神障碍的情况下的自杀未遂方面发挥着重要作用。易怒和抑郁气质是有精神障碍的受试者的额外风险因素。环性气质的双重作用非常有趣：它虽然对自杀行为有保护作用，但在患有精神障碍的受试者中也有阴暗面。
