卒中后1年的自杀意念：一项中国全国性调查。

Suicidal ideation at 1-year post-stroke: A nationwide survey in China.

作者信息

Yang Yang, Shi Yu-Zhi, Zhang Ning, Wang Shuo, Ungvari Gabor S, Ng Chee H, Wang Yi-Long, Zhao Xing-Quan, Wang Yong-Jun, Wang Chun-Xue, Xiang Yu-Tao

机构信息

Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; Department of Neuropsychiatry & Behavioral Neurology and Clinical Psychology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.

Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.

出版信息

Gen Hosp Psychiatry. 2017 Jan-Feb;44:38-42. doi: 10.1016/j.genhosppsych.2016.09.006. Epub 2016 Sep 29.

DOI:10.1016/j.genhosppsych.2016.09.006

PMID:28041574

Abstract

OBJECTIVE

Few studies on suicidal ideation have been conducted in post-stroke patients in China. This national study examined suicidal ideation at 1-year post-stroke and explored its demographic and clinical correlates.

METHODS

A total of 1418 patients with ischemic stroke were included in 56 hospitals nationwide. Demographic, clinical characteristics and neuro-imaging information were collected with standardized instruments, including assessment of stroke severity, depression, cognitive impairment, stroke recurrence, physical disability and insomnia. Suicidal ideation was measured using item 3 of the Hamilton Rating Scale for Depression.

RESULTS

The frequency of suicidal ideation in this study was 6.6%. Multivariate analyses revealed that disability (OR=2.07, 95% CI=1.09-3.05), stroke recurrence (OR=4.13, 95% CI=1.74-9.77) and insomnia early (OR=1.87, 95% CI=1.03-3.39), middle (OR=2.66, 95% CI=1.46-4.85) and late (OR=2.35, 95% CI=1.31-4.19) at the 1-year follow-up and post-stroke depression (OR=2.16, 95% CI=1.23-3.82) were significantly associated with post-stroke suicidal ideation.

CONCLUSION

Post-stroke depression, disability, insomnia and stroke recurrence are possible risk factors of suicidal ideation that warrant attention in clinical practice.

摘要

目的

中国针对卒中后患者自杀意念的研究较少。这项全国性研究调查了卒中后1年的自杀意念，并探讨了其人口统计学和临床相关因素。

方法

全国56家医院共纳入1418例缺血性卒中患者。使用标准化工具收集人口统计学、临床特征和神经影像学信息，包括卒中严重程度、抑郁、认知障碍、卒中复发、身体残疾和失眠的评估。采用汉密尔顿抑郁评定量表第3项测量自杀意念。

结果

本研究中自杀意念的发生率为6.6%。多因素分析显示，残疾（比值比[OR]=2.07，95%置信区间[CI]=1.09-3.05）、卒中复发（OR=4.13，95%CI=1.74-9.77）以及1年随访时早期（OR=1.87，95%CI=1.03-3.39）、中期（OR=2.66，95%CI=1.46-4.85）和晚期（OR=2.35，95%CI=1.31-4.19）的失眠以及卒中后抑郁（OR=2.16，95%CI=1.23-3.82）与卒中后自杀意念显著相关。