Lalthankimi Ralte, Nagarajan Padmavathi, Menon Vikas, Olickal Jeby Jose
College of Nursing (Psychiatric Nursing), Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
J Neurosci Rural Pract. 2021 Jan;12(1):122-128. doi: 10.1055/s-0040-1721558. Epub 2021 Jan 29.
Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups.
精神障碍对自杀死亡有很大影响。因此,本研究旨在确定重度抑郁症(MDD)患者中自杀行为的患病率及其相关因素。
这项横断面分析研究是在2019年3月至10月期间,对在本地治里一家三级护理中心精神科门诊被诊断为MDD的18至65岁个体进行的。使用汉密尔顿抑郁量表评估抑郁严重程度,并使用哥伦比亚自杀严重程度评定量表来发现自杀行为。
该研究中的166名参与者,平均(标准差)年龄为40(11)岁,大多数为女性(76%)。超过三分之一(37%)患有重度或极重度抑郁症,自杀意念、计划和企图的患病率分别为83%、24%和35%。在调整协变量后,抑郁严重程度和失业与自杀企图显著相关(调整患病率比[aPR]=11.4和1.9),极重度抑郁症与自杀意念相关(aPR=1.6)。在140名有自杀意念的个体中,45名(32%)意念频率为每周2至3次,69名(50%)意念持续1小时,36名(26%)能够轻松控制意念,12%有自杀意念主要是为了结束或停止痛苦。
MDD患者的自杀意念和企图显著高发,且抑郁严重程度与之显著相关。早期识别高危自杀行为并实施有效的预防干预措施对于减少这些人群的自杀死亡是必要的。