1 Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.
2 Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada.
Can J Psychiatry. 2017 Oct;62(10):726-734. doi: 10.1177/0706743717715207. Epub 2017 Jul 4.
To predict suicidal ideation in people with schizophrenia, certain studies have measured its relationship with the variables of defeat and entrapment. The relationships are positive, but their interactions remain undefined. To further their understanding, this research sought to measure the relationship between suicidal ideation with the variables of loss, entrapment, and humiliation.
The convenience sample included 30 patients with schizophrenia spectrum disorders. The study was prospective (3 measurement times) during a 6-month period. Results were analyzed by stepwise multiple regression.
The contribution of the 3 variables to the variance of suicidal ideation was not significant at any of the 3 times (T1: 16.2%, P = 0.056; T2: 19.9%, P = 0.117; T3: 11.2%, P = 0.109). Further analyses measured the relationship between the variables of stigmatization, perceived cognitive dysfunction, symptoms, depression, self-esteem, reason to live, spirituality, social provision, and suicidal ideation. Stepwise multiple regression demonstrated that the contribution of the variables of stigmatization and perceived cognitive dysfunction to the variance of suicidal ideation was significant at all 3 times (T1: 41.7.5%, P = 0.000; T2: 35.2%, P = 0.001; T3: 21.5%, P = 0.012). Yet, over time, the individual contribution of the variables changed: T1, stigmatization (β = 0.518; P = 0.002); T2, stigmatization (β = 0.394; P = 0.025) and perceived cognitive dysfunction (β = 0.349; P = 0.046). Then, at T3, only perceived cognitive dysfunction contributed significantly to suicidal ideation (β = 0.438; P = 0.016).
The results highlight the importance of the contribution of the variables of perceived cognitive dysfunction and stigmatization in the onset of suicidal ideation in people with schizophrenia spectrum disorders.
有研究测量了精神分裂症患者的挫败感和困境与自杀意念之间的关系，以此预测自杀意念。这些关系是正向的，但相互作用仍不明确。为了进一步理解这一现象，本研究旨在测量自杀意念与失落感、困境和屈辱感之间的关系。
采用方便抽样法，选取 30 名精神分裂症谱系障碍患者作为研究对象。该研究为前瞻性研究（3 次测量时间），持续 6 个月。采用逐步多元回归分析结果。
在任何 3 次测量时间（T1：16.2%，P=0.056；T2：19.9%，P=0.117；T3：11.2%，P=0.109）中，3 个变量对自杀意念方差的贡献均不显著。进一步分析测量了耻辱感、认知功能障碍感知、症状、抑郁、自尊、生存理由、灵性、社会支持与自杀意念之间的关系。逐步多元回归分析表明，在所有 3 次测量时间中，耻辱感和认知功能障碍感知这两个变量对自杀意念方差的贡献均具有统计学意义（T1：41.7.5%，P=0.000；T2：35.2%，P=0.001；T3：21.5%，P=0.012）。然而，随着时间的推移，变量的个体贡献发生了变化：T1，耻辱感（β=0.518；P=0.002）；T2，耻辱感（β=0.394；P=0.025）和认知功能障碍感知（β=0.349；P=0.046）。然后，在 T3，只有认知功能障碍感知对自杀意念有显著影响（β=0.438；P=0.016）。
研究结果强调了认知功能障碍感知和耻辱感变量对精神分裂症谱系障碍患者自杀意念发生的重要性。
