Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Roma, Italy.
IRCCS NEUROMED, Pozzilli, Roma, Italy.
Int J Psychiatry Clin Pract. 2021 Nov;25(4):344-349. doi: 10.1080/13651501.2020.1790613. Epub 2020 Jul 15.
The aim of this study was to investigate the relationship between suicidal ideation and neurological, psychological, and psychiatric features in patients with blepharospasm (BSP).
We enrolled 70 BSP patients and 80 control subjects. All participants underwent a psychiatric and psychometric evaluation: Structured Clinical Interview, Clinical Global Impression, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Columbia-Suicide Severity Rating Scale, Beck Hopelessness Scale, Temperament Evaluation of Memphis, Pisa, San Diego Auto-questionnaire. BSP severity was assessed using the Blepharospasm Severity Rating Scale.
Suicidal ideation was reported in 18% of BSP patients and 6% had current suicidal ideation. 83% of BSP patients had severe hopelessness. BSP patients presented an increased sense of hopelessness (OR= 1.39, 95% CI = 1.13/1.70) and a pronounced depressive temperament (OR= 1.36, 95% CI = 1.12/1.65). Suicidal ideation in BSP patients correlated with psychiatric disorders (OR = 3.96, 95% CI = 1.23/12.74) and higher scores on the HAM-A (OR = 1.11, 95% CI = 1.02/1.20), HAM-D (OR = 1.18, 95% CI = 1.05/1.32), CGI (OR = 1.85, 95% CI = 1.18/2.90), TEMPS-A Cyclothymia (OR = 1.16, 95% CI = 1.02/1.31).
Our findings suggest the presence of suicidal ideation and severe hopelessness in BSP patients.KEY POINTSBSP patients as compared to controls more frequently reported the presence of a psychiatric disorder and more severe anxiety and depressive symptoms, psychopathology on the CGI, suicidal ideation, and hopelessness.BSP patients with prevalent cyclothymic temperament had more severe suicidal ideation, suggesting an increased suicide risk most likely due to difficulties in psychological adaptation to changing environments, including the neurological disease.A psychiatric assessment is recommended for patients with this condition, with possible referral to a suicide prevention centre.
本研究旨在探讨眼睑痉挛（BSP）患者自杀意念与神经、心理和精神特征之间的关系。
我们纳入了 70 例 BSP 患者和 80 例对照者。所有参与者均接受了精神病学和心理测量评估：结构临床访谈、临床总体印象、汉密尔顿焦虑量表、汉密尔顿抑郁量表、哥伦比亚自杀严重程度评定量表、贝克绝望量表、孟菲斯、比萨、圣地亚哥自动问卷的气质评估。使用眼睑痉挛严重程度评定量表评估 BSP 严重程度。
18%的 BSP 患者报告有自杀意念，6%的患者目前有自杀意念。83%的 BSP 患者有严重的绝望感。BSP 患者表现出更强的绝望感（OR=1.39，95%CI=1.13/1.70）和明显的抑郁气质（OR=1.36，95%CI=1.12/1.65）。BSP 患者的自杀意念与精神障碍（OR=3.96，95%CI=1.23/12.74）和更高的 HAM-A 评分（OR=1.11，95%CI=1.02/1.20）、HAM-D 评分（OR=1.18，95%CI=1.05/1.32）、CGI 评分（OR=1.85，95%CI=1.18/2.90）、TEMPS-A 环性心境（OR=1.16，95%CI=1.02/1.31）相关。
我们的研究结果表明，BSP 患者存在自杀意念和严重的绝望感。
与对照组相比，BSP 患者更频繁地报告存在精神障碍以及更严重的焦虑和抑郁症状、CGI 上的精神病理学、自杀意念和绝望感。有频发环性心境气质的 BSP 患者有更严重的自杀意念，这表明自杀风险增加，这可能是由于他们难以适应不断变化的环境，包括神经系统疾病，导致心理适应困难。建议对这类患者进行精神病学评估，并可能转介到自杀预防中心。
