自杀风险与情感气质评定的关联。

Association of suicidal risk with ratings of affective temperaments.

机构信息

Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Lucio Bini Mood Disorders Center, Cagliari, Sardinia, Italy; International Consortium for Bipolar & Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA.

International Consortium for Bipolar & Psychotic Disorders Research, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.

出版信息

J Affect Disord. 2018 Mar 15;229:322-327. doi: 10.1016/j.jad.2017.12.061. Epub 2018 Jan 3.

DOI:10.1016/j.jad.2017.12.061

PMID:29329066

Abstract

BACKGROUND

Ratings of particular temperament-types with the TEMPS-A autoquestionnaire have been associated with suicidal risk, and combinations of such ratings may enhance the association. However, the predictive value of scores for individual temperaments and combinations remains to be quantified.

METHOD

We evaluated associations of TEMPS-A ratings for anxious (anx), cyclothymic (cyc), dysthymic (dys), hyperthymic (hyp) and irritable (irr) temperaments, with a history of suicidal acts or reported suicidal ideation in 882 patients with bipolar (BD; n = 509), major depressive (MDD; n = 268) or anxiety (ANX; n = 105) disorders.

RESULTS

With BD, scores for cyc and irr were highest and anx lowest; with MDD, dys scored highest, hyp lowest; anx was highest with ANX and MDD. Women (n = 497) had higher anx and cyc scores than men; scores for irr and hyp decreased with age. Scores for dys, anx, and cyc, were higher, and hyp lower, with greater HDRS depression ratings. Among 347 suicidal subjects (112 with attempts), cyc, dys, and irr scores were higher, hyp lower. Pooled score [cyc+ dys+ irr - hyp] best distinguished subjects with suicide attempts versus nonsuicidal subjects, including in Receiver-Operating Characteristic (ROC) analysis (AUC for acts = 70.1% [64.9- 75.3]). Multivariable modeling associated suicidal acts with TEMPS-A [cyc+ dys+ irr - hyp] composite-score, depression severity, BD or MDD diagnosis, and older at illness-onset.

CONCLUSIONS

Subjects with suicidal acts or ideation were best distinguished by composite TEMPS-A score [cyc+ dys+ irr - hyp]. These factors should help to identify those at suicidal risk.

摘要

背景

使用 TEMPS-A 自陈式问卷对特定气质类型进行评分与自杀风险相关，此类评分的组合可能会增强这种关联。然而，个体气质和组合评分的预测值仍有待量化。

方法

我们评估了 TEMPS-A 对焦虑（anx）、环性（cyc）、恶劣心境（dys）、高敏（hyp）和易激惹（irr）气质的评分与双相障碍（BD；n=509）、重度抑郁障碍（MDD；n=268）或焦虑障碍（ANX；n=105）患者自杀行为或自杀意念史之间的关联。

结果

BD 患者中，cyc 和 irr 评分最高，anx 评分最低；MDD 患者中，dys 评分最高，hyp 评分最低；ANX 和 MDD 患者中 anx 评分最高。女性（n=497）的 anx 和 cyc 评分高于男性；irr 和 hyp 评分随年龄增长而降低。HDRS 抑郁评分越高，dys、anx 和 cyc 评分越高，hyp 评分越低。在 347 例有自杀行为的受试者（112 例有自杀未遂）中，cyc、dys 和 irr 评分较高，hyp 评分较低。TEMPS-A 评分（cyc+dys+irr-hyp）综合评分能更好地区分有自杀未遂的受试者与无自杀未遂的受试者，包括在受试者工作特征（ROC）分析中（行为 AUC=70.1%[64.9-75.3]）。多变量模型将自杀行为与 TEMPS-A [cyc+dys+irr-hyp]复合评分、抑郁严重程度、BD 或 MDD 诊断以及发病年龄较大相关联。