Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Suicide Life Threat Behav. 2019 Oct;49(5):1360-1378. doi: 10.1111/sltb.12529. Epub 2018 Nov 19.
To evaluate the effects of mood and anxiety symptoms in relation to personality dimensions and clinical features such as trauma and substance use on suicidal behaviors in a longitudinal sample of individuals with bipolar illness (BP) and healthy controls (HC).
Mood, personality, and clinical features were assessed in 151 individuals with BP I and 119 HC. Clinical data were collected at baseline and at 2-year follow-up. Personality traits were measured using the NEO PI-R.
In bivariate analyses, personality measures were significantly different between BP and HC, and between BP based on suicide attempt history. However, in regression analyses, baseline measures of depression, mania, anxiety, trauma, education, and age of BP onset correlated with personality domains, while a history of suicide attempts did not. Logistic regressions showed that prospective depression or mania, and a pattern of mixed mood features and chronicity of illness, along with two Neuroticism facet scores (N4-Self-Consciousness and N6-Vulnerability) were predictive of suicide ideation (SI) in the 2-year follow-up period.
While dimensions of personality, trauma, and substance use clearly correlated with suicidal behaviors in BP, in multivariate models emerging mood symptoms were the most robust predictors of suicidality. These results reinforce the importance and attributable role of mood and anxiety symptoms in evaluating suicidal risk.
评估心境和焦虑症状与人格维度以及创伤和物质使用等临床特征相关，对双相情感障碍（BP）患者和健康对照（HC）个体的自杀行为的影响。
对 151 名 BP I 患者和 119 名 HC 进行心境、人格和临床特征评估。临床数据在基线和 2 年随访时收集。使用 NEO PI-R 测量人格特质。
在双变量分析中，BP 和 HC 之间、基于自杀企图史的 BP 之间的人格测量值存在显著差异。然而，在回归分析中，BP 的基线抑郁、躁狂、焦虑、创伤、教育和发病年龄的测量值与人格领域相关，而自杀企图史则不相关。逻辑回归显示，前瞻性抑郁或躁狂，以及混合心境特征和疾病慢性化模式，以及两个神经质方面评分（N4-自我意识和 N6-脆弱性），是 2 年随访期间自杀意念（SI）的预测因子。
虽然人格、创伤和物质使用的维度与 BP 中的自杀行为明显相关，但在多变量模型中，出现的心境症状是自杀倾向的最有力预测因子。这些结果强调了评估自杀风险时心境和焦虑症状的重要性和归因作用。
