Chakroun Mariem, Zgueb Yosra, Khaled Donia Ben, Ouali Uta, Jomli Rabaa, Nacef Fethi
Service de Psychiatrie «A», Hôpital Razi, la Manouba, Tunis, Tunisie.
Pan Afr Med J. 2020 Oct 2;37:116. doi: 10.11604/pamj.2020.37.116.24787. eCollection 2020.
Suicide is a public health problem affecting majority of patients with psychiatric diseases, including bipolar disorder (BD). The purpose of this study was to estimate the prevalence of suicide attempts (SAs) and to identify different factors associated with it in a population of patients with bipolar disorder type I (BD I). We conducted a cross-sectional and descriptive study of 150 patients. We used a fact sheet, questionnaires assessing affective temperaments, alcohol addiction and drug addiction. A comparison between suicidal (23,3%, n = 35) and non-suicidal (76,7%, n = 115) subjects enabled the identification of the following risk factors for suicide: cannabis addiction, addiction to psychotropic drugs, advanced age, a family history of BD, depression, SA and suicide deaths, a personal somatic history, a personality disorder associated, in particular, with histrionic personality, depressive temperament, a first thymic depressive episode, recurrent thymic episodes and long-term disease progression. Two protective factors were also identified: valproic acid and a higher number of siblings. In a multivariate study risk factors included: age, a family history of BD, a family history of SA and cannabis addiction. Particular attention should be given to determinants associated with suicidal behavior in BD I patients in order to adopt effective preventive and therapeutic strategies.
自杀是一个影响包括双相情感障碍(BD)在内的大多数精神疾病患者的公共卫生问题。本研究的目的是估计自杀未遂(SA)的患病率,并确定与I型双相情感障碍(BD I)患者群体中自杀未遂相关的不同因素。我们对150名患者进行了横断面描述性研究。我们使用了一份情况说明书、评估情感气质、酒精成瘾和药物成瘾的问卷。对有自杀行为(23.3%,n = 35)和无自杀行为(76.7%,n = 115)的受试者进行比较,确定了以下自杀风险因素:大麻成瘾、精神药物成瘾、高龄、双相情感障碍家族史、抑郁、自杀未遂和自杀死亡、个人躯体病史、特别是与表演型人格相关的人格障碍、抑郁气质、首次胸腺抑郁发作、复发性胸腺发作和长期疾病进展。还确定了两个保护因素:丙戊酸和较多的兄弟姐妹数量。在多变量研究中,风险因素包括:年龄、双相情感障碍家族史、自杀未遂家族史和大麻成瘾。应特别关注BD I患者中与自杀行为相关的决定因素,以便采取有效的预防和治疗策略。