青少年双相情感障碍与重度抑郁症自杀未遂的比较：系统评价和荟萃分析。
Suicide Attempts in Juvenile Bipolar Versus Major Depressive Disorders: Systematic Review and Meta-Analysis.
机构信息
Institute of Psychiatry and Psychology, Catholic University of the Sacred Heart, Rome.
Child Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Harvard Medical School, Boston, MA, and International Consortium for Mood and Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA.
出版信息
J Am Acad Child Adolesc Psychiatry. 2017 Oct;56(10):825-831.e3. doi: 10.1016/j.jaac.2017.07.783. Epub 2017 Aug 3.
OBJECTIVE
Suicide attempts are prevalent in association with major mood disorders, and risk is greater with bipolar disorder (BD) than major depressive disorder (MDD) in adults. There may be similar relationships in juvenile mood disorders, but the evidence has not been compiled systematically and quantitatively.
METHOD
We searched for reports of studies comparing rates of suicide attempts in children or adolescents diagnosed with BD or MDD, and applied random-effects meta-analysis.
RESULTS
In 6 reports from 1995 to 2017, with 2,303 participants diagnosed with mood disorder from the United States and South Korea, aged 3 to 18 years, rates of suicide attempts differed significantly by diagnosis: BD (31.5%) > MDD (20.5%) > hypomania or mania-only (8.49%). Risk of suicide attempts differed (BD > MDD) highly significantly by meta-analysis (odds ratio [OR] = 1.71, CI = 1.33-2.20, p < .0001), and was very similar if a study with attempts and suicidal ideation was excluded (OR = 1.64, CI = 1.26-2.15, p < .0001).
CONCLUSION
Risk of suicide attempts in juvenile mood disorder patients ranked: BD > MDD >> hypomania or mania-only >> juvenile general population.
目的
自杀未遂在重性心境障碍患者中较为常见，且双相障碍（BD）患者的自杀风险高于重性抑郁障碍（MDD）患者。青少年心境障碍患者可能也存在类似的关系，但尚未对这些证据进行系统和定量的综合。
方法
我们检索了比较美国和韩国的 3 至 18 岁确诊为 BD 或 MDD 的儿童或青少年自杀未遂发生率的研究报告，并应用随机效应荟萃分析。
结果
1995 年至 2017 年期间的 6 项研究报告中，共有 2303 名来自美国和韩国的心境障碍患者参与，这些患者的年龄为 3 至 18 岁。不同诊断的自杀未遂发生率存在显著差异：BD（31.5%）> MDD（20.5%）>轻躁狂或仅有躁狂（8.49%）。荟萃分析显示自杀未遂的风险存在显著差异（BD > MDD）（比值比 [OR] = 1.71，置信区间 [CI] = 1.33-2.20，p <.0001），如果排除有自杀意念的研究，差异非常显著（OR = 1.64，CI = 1.26-2.15，p <.0001）。
结论
青少年心境障碍患者的自杀未遂风险依次为：BD > MDD > 仅有轻躁狂或躁狂 > 青少年普通人群。
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