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躯体症状与首发重性抑郁障碍患者自杀意念的相关性。

The association between somatic symptoms and suicidal ideation in Chinese first-episode major depressive disorder.

机构信息

Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.

Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.

出版信息

J Affect Disord. 2019 Feb 15;245:17-21. doi: 10.1016/j.jad.2018.10.110. Epub 2018 Oct 17.

Abstract

BACKGROUND

Somatic symptoms are prevalent in patients with major depressive disorder (MDD) and often associated with a high risk of suicide. However, which somatic symptoms display as significant risk factors for suicidal ideation (SI) is still poorly understood in MDD.

METHODS

Two thousand and seventeen Chinese patients with first-episode MDD from the National Survey on Symptomatology of Depression were included in this study. A doctor-rating assessment questionnaire was constructed to evaluate depression related somatic symptoms, and stepwise logistic regression analysis was performed to explore the relationship between somatic symptoms and SI.

RESULTS

Our results showed a high prevalence of current SI in first-episode MDD (50.87%), while no significant gender differences (53.32% vs. 49.26%, P = 0.076) were observed. In addition, patients who have more somatic symptoms would be at the higher risk to elicit SI, and stepwise logistic regression analysis indicated that age (β = -0.020, P < 0.001), Pre-verbal physical complaints (β = 0.356, P = 0.001), Sensory system complaints (β = 0.707, P = 0.000), Other pain conditions (β = 0.434, P < 0.001), Late insomnia (β = 0.267, P = 0.008), Hypersomnia (β = 0.936, P < 0.001), Weight loss (β = 0.272, P = 0.006), Hyposexuality (β = 0.513, P = P < 0.001) were strongly associated with current SI in first-episode Chinese major depression.

CONCLUSIONS

Somatic symptoms are strongly associated with SI in first-episode MDD. It is suggestive for clinicians to show concerns for patients' somatic symptoms in practice.

摘要

背景

躯体症状在患有重度抑郁症(MDD)的患者中很常见,并且通常与自杀风险高有关。然而,在 MDD 中,哪些躯体症状表现为自杀意念(SI)的显著危险因素仍知之甚少。

方法

本研究纳入了来自全国症状调查的 1737 名首发 MDD 中国患者。构建了医生评定评估问卷来评估与抑郁相关的躯体症状,并进行逐步逻辑回归分析以探讨躯体症状与 SI 之间的关系。

结果

我们的结果显示首发 MDD 中当前 SI 的发生率较高(50.87%),但未观察到显著的性别差异(53.32% vs. 49.26%,P=0.076)。此外,躯体症状较多的患者发生 SI 的风险更高,逐步逻辑回归分析表明年龄(β=-0.020,P<0.001)、言语前躯体抱怨(β=0.356,P=0.001)、感觉系统抱怨(β=0.707,P=0.000)、其他疼痛状况(β=0.434,P<0.001)、晚发性失眠(β=0.267,P=0.008)、嗜睡(β=0.936,P<0.001)、体重减轻(β=0.272,P=0.006)、性欲减退(β=0.513,P<0.001)与首发中国重度抑郁症患者的当前 SI 强烈相关。

结论

躯体症状与首发 MDD 中的 SI 强烈相关。这表明临床医生在实践中应关注患者的躯体症状。

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