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共病惊恐障碍作为门诊抑郁症患者自杀未遂的独立危险因素。

Comorbid panic disorder as an independent risk factor for suicide attempts in depressed outpatients.

作者信息

Nam Yoon-Young, Kim Chan-Hyung, Roh Daeyoung

机构信息

Division of Planning and Public Relations, National Center for Mental Health, Seoul, Republic of Korea.

Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Compr Psychiatry. 2016 May;67:13-8. doi: 10.1016/j.comppsych.2016.02.011. Epub 2016 Feb 17.

Abstract

OBJECTIVE

Although comorbid panic disorder is associated with more severe symptoms and poorer therapeutic response in depressive patients, the relationship between panic disorder and risk of suicide attempt has not been confirmed. This study aimed to examine the relationship between comorbid panic disorder and clinical characteristics associated with suicidal risk as well as the likelihood of suicide attempt.

METHOD

A total of 223 outpatients with current major depressive disorder participated in the study. Both subjects with panic disorder (33%) and those without panic disorder (67%) were compared based on history of suicide attempts, current psychopathologies, and traits of impulsivity and anger.

RESULTS

Subjects with panic disorder had higher levels of impulsivity, depression, and hopelessness and were more likely to report a history of suicide attempts. Subjects with panic disorder were younger at the time of first suicide attempt than those without panic disorder. Logistic regression analyses indicated that comorbid panic disorder was significantly associated with a history of suicide attempts after adjusting for other clinical correlates (odds ratio = 2.8; p < 0.01).

CONCLUSIONS

These findings suggest that comorbid panic disorder in patients with major depressive disorder may be associated with a more severe burden of illness and may independently increase the likelihood of suicide attempt.

摘要

目的

尽管共病惊恐障碍与抑郁症患者更严重的症状及较差的治疗反应相关,但惊恐障碍与自杀未遂风险之间的关系尚未得到证实。本研究旨在探讨共病惊恐障碍与自杀风险相关临床特征以及自杀未遂可能性之间的关系。

方法

共有223名当前患有重度抑郁症的门诊患者参与了本研究。基于自杀未遂史、当前精神病理学状况以及冲动性和愤怒特质,对患有惊恐障碍的受试者(33%)和未患有惊恐障碍的受试者(67%)进行了比较。

结果

患有惊恐障碍的受试者具有更高水平的冲动性、抑郁和绝望感,且更有可能报告有自杀未遂史。患有惊恐障碍的受试者首次自杀未遂时的年龄比未患有惊恐障碍的受试者更小。逻辑回归分析表明,在调整其他临床相关因素后,共病惊恐障碍与自杀未遂史显著相关(比值比 = 2.8;p < 0.01)。

结论

这些发现表明,重度抑郁症患者共病惊恐障碍可能与更严重的疾病负担相关,并可能独立增加自杀未遂的可能性。

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