Hung Ching-I, Liu Chia-Yih, Yang Ching-Hui
Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Chang-Gung University School of Medicine, Taoyuan, Taiwan.
PLoS One. 2016 Dec 16;11(12):e0168202. doi: 10.1371/journal.pone.0168202. eCollection 2016.
No study has investigated the percentages of and factors related to unintentional injuries among psychiatric outpatients with major depressive disorder (MDD). This study aimed to investigate these issues.
One-hundred and forty-one outpatients with MDD at baseline were enrolled from psychiatric outpatients by systematic sampling, and 119 subjects attended a one-year follow-up. Self-reported unintentional injuries in the past one year were recorded. Psychiatric disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The severity of depression was evaluated by the Hamilton Depression Rating Scale. Other data, including body weight and height, cigarette smoking, headaches, and medications, were collected. Generalized Estimating Equations were used to investigate independent factors related to unintentional injuries.
At baseline and follow-up, 40.4% and 27.7% of subjects had experienced at least one unintentional injury in the past one year, respectively. About half of subjects with unintentional injuries needed medical treatment for injuries and had functional impairment due to injuries. A greater severity of depression, cigarette smoking, a higher body mass index, and an older age were independent risk factors related to unintentional injuries.
Unintentional injuries that increased the medical burden and functional impairment were common among outpatients with MDD and should not be neglected. Treatment of depression, control of body weight, and quitting cigarettes might be helpful to prevent unintentional injuries.
尚无研究调查过重度抑郁症（MDD）门诊患者中意外伤害的发生率及相关因素。本研究旨在调查这些问题。
通过系统抽样从精神科门诊患者中选取141例基线时患有MDD的门诊患者，119例患者接受了为期一年的随访。记录过去一年中自我报告的意外伤害情况。使用《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）的结构化临床访谈来诊断精神疾病。用汉密尔顿抑郁量表评估抑郁的严重程度。收集包括体重、身高、吸烟、头痛和用药情况等其他数据。采用广义估计方程来研究与意外伤害相关的独立因素。
在基线和随访时，分别有40.4%和27.7%的患者在过去一年中经历过至少一次意外伤害。约一半的意外伤害患者因伤需要接受治疗且因伤出现功能障碍。抑郁程度较重、吸烟、体重指数较高和年龄较大是与意外伤害相关的独立危险因素。
增加医疗负担和功能障碍的意外伤害在MDD门诊患者中很常见，不应被忽视。治疗抑郁症、控制体重和戒烟可能有助于预防意外伤害。
