Jeon Hong Jin, Woo Jong-Min, Kim Hyo-Jin, Fava Maurizio, Mischoulon David, Cho Seong Jin, Chang Sung Man, Park Doo-Heum, Kim Jong Woo, Yoo Ikki, Heo Jung-Yoon, Hong Jin Pyo
Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.; Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine, Seoul, Republic of Korea.; Stress Research Institute, Inje University, Seoul, Republic of Korea.
Psychiatry Investig. 2016 Nov;13(6):609-615. doi: 10.4306/pi.2016.13.6.609. Epub 2016 Nov 24.
Although somatic symptoms are common complaints of patients with major depressive disorder (MDD), their associations with suicide are still unclear.
A total of 811 MDD outpatients of aged between 18 to 64 years were enrolled nationwide in Korea with the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Depression and Somatic Symptom Scale (DSSS).
On stepwise regression analysis, current suicidality scores were most strongly associated with chest pain in men, and neck or shoulder pain in women. Severe chest pain was associated with higher current suicidality scores in men than in women, whereas severe neck or shoulder pain showed no significant differences between the genders. In conclusion, MDD patients of both sexes with suicidal ideation showed significantly more frequent and severe somatic symptoms than those without. Current suicidal risk was associated with chest pain in men, and neck or shoulder pain in women.
We suggest that clinicians pay attention to patients' somatic symptoms in real world practice.
尽管躯体症状是重度抑郁症(MDD)患者常见的主诉,但它们与自杀之间的关联仍不明确。
在韩国全国范围内,共招募了811名年龄在18至64岁之间的MDD门诊患者,使用迷你国际神经精神访谈量表(MINI)的自杀观念模块以及抑郁和躯体症状量表(DSSS)进行评估。
逐步回归分析显示,当前的自杀观念得分在男性中与胸痛关联最为密切,在女性中与颈部或肩部疼痛关联最为密切。严重胸痛在男性中与更高的当前自杀观念得分相关,而在女性中则不然,严重颈部或肩部疼痛在两性之间无显著差异。总之,有自杀观念的男女MDD患者比没有自杀观念的患者表现出更频繁、更严重的躯体症状。当前的自杀风险在男性中与胸痛相关联,在女性中与颈部或肩部疼痛相关联。
我们建议临床医生在实际临床实践中关注患者的躯体症状。