Yildirim Feride, Küçükgöncü Suat, Beştepe Engin Emrem, Yildirim Murat Serkan
Clinic of Psychiatry, Erzurum Education Research Hospital, Erzurum, Turkey.
Department of Psychiatry, Yale University, New Haven CT, USA.
Noro Psikiyatr Ars. 2014 Jun;51(2):133-140. doi: 10.4274/npa.y6802. Epub 2014 Jun 1.
Unipolar depression is an important psychiatric disorder that leads to an increased risk of suicide. However, not all depression patients attempt suicide. This reflects the presence of other factors that may be related to suicide other than the sole presence of psychopathology. Drawing upon the clinical evidence linking childhood abuse and neglect experiences with suicide; this study aimed at investigating the relationship of childhood abuse and neglect experiences with suicide attempts in patients with unipolar depression.
One hundred six unipolar depressed patients between the ages of 18 and 65 were included in the study. Patients with comorbid psychiatric disorders, neurological disorders, alcohol-substance abuse problems, and a Beck Depression Inventory (BDI) score of <17 were excluded from the study. The BDI, Childhood Trauma Questionnaire (CTQ-28), State-Trait Anger Expression Inventory (STAXI), and the Suicide Behavior Questionnaire (SBQ) were administered to all patients. Suicidal and non-suicidal cases were determined according to clinic interviews and the patients' responses in the SBQ.
Sixty-four patients have previously attempted suicide. Although there was no significant difference between unipolar depression patients with a history of suicide attempts and patients with no history of suicide attempts in terms of average age, education and marital status, however, female/male ratio in the former group was determined to be significantly higher. BDI, STAXI continuous anger and outward anger average scores, and average CTQ-28 emotional abuse, physical abuse and total scores were significantly higher in the group with a history of suicide attempts. The predictors of suicide attempts were higher BDI and CTQ-28 physical abuse scores and female gender. The predictors for average SBQ scores were determined as higher BDI, CTQ-28 sexual abuse, and STAXI outward anger and continuous anger scores.
Childhood physical and sexual abuse experiences are important factors in evaluating the presence of suicide attempts and risk of suicide in patients with unipolar depression. Careful questioning of traumatic childhood experiences during psychiatric examinations and monitoring of depression patients is crucial in determining treatment protocols and preventing suicide attempts.
单相抑郁症是一种重要的精神疾病，会增加自杀风险。然而，并非所有抑郁症患者都会尝试自杀。这反映出除了精神病理学因素外，可能还有其他与自杀相关的因素。基于将童年期虐待和忽视经历与自杀联系起来的临床证据，本研究旨在调查单相抑郁症患者童年期虐待和忽视经历与自杀未遂之间的关系。
本研究纳入了106名年龄在18至65岁之间的单相抑郁症患者。患有共病精神障碍、神经疾病、酒精-物质滥用问题以及贝克抑郁量表（BDI）得分<17的患者被排除在研究之外。对所有患者进行了BDI、儿童创伤问卷（CTQ-28）、状态-特质愤怒表达量表（STAXI）和自杀行为问卷（SBQ）的评估。根据临床访谈和患者在SBQ中的回答确定自杀和非自杀病例。
64名患者曾有过自杀未遂经历。虽然有自杀未遂史的单相抑郁症患者与无自杀未遂史的患者在平均年龄、教育程度和婚姻状况方面没有显著差异，但是，前一组的女性/男性比例明显更高。有自杀未遂史的组中，BDI、STAXI持续愤怒和外向愤怒平均得分以及CTQ-28情感虐待、身体虐待和总分均显著更高。自杀未遂的预测因素是较高的BDI和CTQ-28身体虐待得分以及女性性别。SBQ平均得分的预测因素被确定为较高的BDI、CTQ-28性虐待以及STAXI外向愤怒和持续愤怒得分。
童年期身体和性虐待经历是评估单相抑郁症患者自杀未遂情况和自杀风险的重要因素。在精神科检查期间仔细询问童年创伤经历以及对抑郁症患者进行监测，对于确定治疗方案和预防自杀未遂至关重要。
