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情感剥夺、社会孤立、羞耻感和被抛弃感等早期适应不良图式与重度抑郁症患者的自杀未遂史有关。

Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders.

作者信息

Ahmadpanah Mohammad, Astinsadaf Sommayyeh, Akhondi Amineh, Haghighi Mohammad, Sadeghi Bahmani Dena, Nazaribadie Marzieh, Jahangard Leila, Holsboer-Trachsler Edith, Brand Serge

机构信息

Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.

Hamadan Islamic Azad University, Hamadan, Iran.

出版信息

Compr Psychiatry. 2017 Aug;77:71-79. doi: 10.1016/j.comppsych.2017.05.008. Epub 2017 Jun 19.

Abstract

BACKGROUND

Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls.

METHOD

Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale.

RESULTS

Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability.

CONCLUSION

Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related.

摘要

背景

精神疾病患者完成自杀或自杀未遂的风险极高。对于重度抑郁症患者而言尤其如此。本研究的目的是探讨有自杀未遂史的重度抑郁症(MDD)患者与无此类病史的MDD患者或健康对照者在早期适应不良图式方面是否存在差异。

方法

90名参与者参与了该研究。其中,30名是近期有自杀未遂行为的MDD患者;30名是患有MDD但无自杀未遂行为的患者,30名是年龄和性别匹配的健康对照者。参与者完成了涵盖社会人口学特征的问卷以及用于评估早期适应不良图式的青年图式问卷(YSQ - RE2R)。专家们使用蒙哥马利 - 阿斯伯格抑郁评定量表对患者的抑郁症进行评分。

结果

在专家对抑郁症状的评分中,患者之间没有差异。与健康对照者相比,MDD患者在诸如寻求认可、消极/悲观和自我控制不足等适应不良图式上得分更高。与无自杀未遂行为的患者和健康对照者相比,有自杀未遂行为的患者在诸如失败、不信任、情绪抑制、社会孤立以及被抛弃/不稳定等维度上得分更高。

结论

与健康对照者相比,MDD患者有更明显的适应不良图式,但这在有自杀未遂史患者中更为显著。结果表明自杀未遂与较差的心理功能有关。

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