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青少年 12-17 岁抑郁的连续性和持续时间及其与非自杀性自伤和自杀意念及行为的关系。

The continuity and duration of depression and its relationship to non-suicidal self-harm and suicidal ideation and behavior in adolescents 12-17.

机构信息

University of Western Australia, Graduate School of Education, Nedlands 6009, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Subiaco 6008, Western Australia, Australia.

Telethon Kids Institute, University of Western Australia, Subiaco 6008, Western Australia, Australia.

出版信息

J Affect Disord. 2017 Oct 1;220:49-56. doi: 10.1016/j.jad.2017.05.050. Epub 2017 May 31.

Abstract

BACKGROUND

There is a significant overlap between non-suicidal self-harm and suicidal ideation and behavior in young people with both symptom continuity and symptom duration implicated in this association.

METHODS

A population sample of Australian 12-17 year olds. Interviewers collected measures for DSM disorders, symptom duration and continuity, and background information from their parents, while young people self-reported symptoms of depression, non-suicidal self-harm and suicidal ideation and behaviors. This report focusses on the 265 young people who met the DSM criteria for Major Depressive Disorder based on their own self-reports.

RESULTS

Relative to young people who had at least one period 2 months or longer without symptoms since first onset, young people who had the continuous presence of depressive symptoms since their first onset had significantly higher odds for life-time self-harm, 12-month self-harm, multiple self-harm, suicidal ideation and suicide attempt within the past 12 months. The duration of depressive symptoms and the continuity of these symptoms each independently contribute to elevating the risks of non-suicidal self-harming and suicidal ideation and behaviors.

LIMITATIONS

Reliance on self-report from the young people and time constraints prohibiting administering diagnostic modules other than the Major Depressive Disorder and estimating self-reported co-morbidity.

CONCLUSIONS

Among young people with a Major Depressive Disorder, self-reports about duration of depressive symptoms as well as the continuity of symptoms, each independently contributes to elevated risks of non-suicidal self-harming and suicidal ideation and behaviors. As well, un-remitting as opposed to episodic symptoms in this group of young people are common and are a powerful indicator of suffering associated with both self-harm and suicidal behavior.

摘要

背景

在有症状连续性和症状持续时间的年轻人中,非自杀性自伤和自杀意念和行为之间存在显著重叠。

方法

澳大利亚 12-17 岁的人群样本。访谈者从他们的父母那里收集 DSM 障碍、症状持续时间和连续性以及背景信息,而年轻人则自我报告抑郁、非自杀性自伤和自杀意念和行为的症状。本报告重点介绍了根据自己的报告符合 DSM 重度抑郁症标准的 265 名年轻人。

结果

与至少有一次持续 2 个月或更长时间无症状的年轻人相比,从首次发病开始就持续出现抑郁症状的年轻人,一生中发生自伤的几率、12 个月内自伤、多次自伤、自杀意念和过去 12 个月内自杀企图的几率显著更高。抑郁症状的持续时间和这些症状的连续性都独立地增加了非自杀性自伤和自杀意念和行为的风险。

局限性

依赖年轻人的自我报告以及时间限制,禁止除重度抑郁症以外的诊断模块,估计自我报告的共病。

结论

在患有重度抑郁症的年轻人中,自我报告的抑郁症状持续时间以及症状的连续性,都独立地增加了非自杀性自伤和自杀意念和行为的风险。此外,在这群年轻人中,没有缓解的症状而不是发作性症状很常见,是与自伤和自杀行为相关的痛苦的有力指标。

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