Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Psychiatry, Children's Medical Center of Dallas, Dallas, TX, USA.
Department of Psychiatry, Children's Medical Center of Dallas, Dallas, TX, USA.
Psychiatry Res. 2017 Nov;257:242-248. doi: 10.1016/j.psychres.2017.07.054. Epub 2017 Jul 29.
Although insomnia has been repeatedly linked with suicide ideation, the reason for the linkage is not clear. The Interpersonal Psychological Theory of Suicide (IPTS) proposes that three core variables (thwarted belongingness, perceived burdensomeness, and acquired capability) are the final common pathway for all risk factors for suicide ideation and behavior. Recent research has suggested that insomnia may be associated with suicide ideation independently of the IPTS. We examined cross-sectional data from 151 psychiatric inpatients (ages 12-17) to determine if the association between insomnia symptoms and a continuous measure of suicide risk (measured as increasingly severe ideation and plan) was explained by the framework of the IPTS. When all IPTS variables and depressive symptoms were included in the model, insomnia symptoms did not contribute unique variance to suicide risk. Perceived burdensomeness and depressive symptoms were found to explain the relationship between insomnia symptoms and suicide risk. Our findings suggest that improved sleep might reduce suicide risk, that management of interpersonal need cognitions might reduce risk in the presence of insomnia symptoms, and reinforce the independent role of depressive symptoms in suicide risk in clinical samples of adolescents.
尽管失眠与自杀意念反复相关，但两者之间的关联原因并不明确。人际心理理论的自杀学说（IPTS）提出，三个核心变量（归属感缺失、被感知的累赘感和习得性自杀能力）是自杀意念和行为所有风险因素的最终共同途径。最近的研究表明，失眠可能与自杀意念有关，与 IPTS 无关。我们分析了来自 151 名精神病住院患者（年龄 12-17 岁）的横断面数据，以确定失眠症状与连续的自杀风险衡量标准（表现为越来越严重的意念和计划）之间的关联是否符合 IPTS 的框架。当模型中纳入所有 IPTS 变量和抑郁症状时，失眠症状并未对自杀风险产生独特的影响。感知到的累赘感和抑郁症状被发现可以解释失眠症状与自杀风险之间的关系。我们的研究结果表明，改善睡眠可能会降低自杀风险，在存在失眠症状的情况下，管理人际需求认知可能会降低风险，并且在青少年的临床样本中，抑郁症状在自杀风险中具有独立作用。
