Janssen Research & Development, LLC, Titusville, NJ, USA.
Janssen Scientific Affairs, LLC, Titusville, NJ, USA.
BMC Psychiatry. 2020 Jul 23;20(1):384. doi: 10.1186/s12888-020-02758-y.
The current analysis utilized data collected via an online patient community platform, PatientsLikeMe (PLM) to compare patient-reported experiences in patients with major depressive disorder (MDD) with suicidal ideation (MDSI) to those with MDD but without suicidal ideation.
PLM members who joined PLM between May-2007 and February-2018 and reported a diagnosis of MDD were included. The MDSI cohort included patients with MDD who reported at least one suicide-related symptom at a severity greater than "none". Demographics, comorbidities, symptoms, and side-effects were compared between MDSI and MDD cohorts. Factors correlated with suicidal ideation (SI) were determined by a random forest procedure.
Patients in the MDSI cohort (n = 266) were younger (median age, 36 vs 44 years) with an earlier disease onset (before 30 years, 83% vs 71%), and a longer diagnosis latency (median, 4 vs 2 years) vs patients in the MDD cohort (n = 11,963). Majority of patients were women in both cohorts (73% vs 83%). Median number of psychiatric comorbidities was higher in the MDSI cohort (4 vs 3). Unprompted symptoms (e.g., loneliness, feeling of hopelessness, social anxiety, impulsivity, and self-hating thoughts) were more frequent in the MDSI cohort. Hopelessness, loneliness, anhedonia, social anxiety, and younger age were highly correlated with suicidal ideation.
This analysis utilized patient-reported data to better understand symptoms, experiences, and characteristics of patients with MDSI compared to patients with MDD. The results identified various risk factors correlated with suicidal ideation that may help guide clinical judgement for patients with MDD who may not voluntarily report suicidal ideation.
本分析利用了从在线患者社区平台 PatientsLikeMe(PLM)收集的数据,比较了有自杀意念(MDSI)的重度抑郁症(MDD)患者与无自杀意念的 MDD 患者的患者报告体验。
纳入了 2007 年 5 月至 2018 年 2 月期间加入 PLM 且报告 MDD 诊断的 PLM 成员。MDSI 队列包括报告至少一种自杀相关症状且严重程度大于“无”的 MDD 患者。比较 MDSI 和 MDD 队列的人口统计学、合并症、症状和副作用。通过随机森林程序确定与自杀意念相关的因素。
MDSI 队列(n=266)的患者年龄更小(中位数年龄 36 岁比 44 岁),发病更早(30 岁之前,83%比 71%),诊断潜伏期更长(中位数 4 年比 2 年),而 MDD 队列(n=11963)的患者年龄更大。两个队列中的大多数患者均为女性(73%比 83%)。MDSI 队列的精神共病中位数更高(4 比 3)。无提示症状(如孤独感、绝望感、社交焦虑、冲动和自我厌恶感)在 MDSI 队列中更常见。无望感、孤独感、快感缺失、社交焦虑和年龄较小与自杀意念高度相关。
本分析利用患者报告数据,更好地了解了有自杀意念的 MDD 患者与无自杀意念的 MDD 患者的症状、体验和特征。结果确定了与自杀意念相关的各种风险因素,这可能有助于指导可能不会主动报告自杀意念的 MDD 患者的临床判断。