Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
Qingdao Mental Health Center, Qingdao University, Qingdao, China.
Transl Psychiatry. 2021 Feb 4;11(1):97. doi: 10.1038/s41398-021-01234-9.
The associated factors of suicide attempts in patients with major depressive disorder (MDD) comorbid with anxiety remains unclear. To the best of our knowledge, this is the first study with a large sample size that examines the risk factors of suicide attempts in first-episode drug-naïve (FEND) MDD patients comorbid with anxiety and includes clinical correlates, metabolic parameters, and thyroid hormone levels. A total of 1718 FEDN MDD patients were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess the symptoms of patients. Metabolic parameters and thyroid hormone levels were measured. The prevalence of suicide attempts in MDD patients comorbid anxiety symptoms was 24.28%, which was 9.51 times higher than that in MDD patients without anxiety symptoms (3.25%). Compared to non-attempters, MDD patients with anxiety symptoms who attempted suicide scored higher on HAMD and HAMA, and had higher systolic blood pressure, higher levels of thyroid stimulating hormone (TSH), and thyroid peroxidases antibody (TPOAb), which were also correlated with suicide attempts in MDD patients comorbid anxiety symptoms. The combination of HAMA score, HAMD score, and TSH could differentiate suicide attempters from non-suicide attempters. Further, the age of onset, illness duration, BMI, TSH, and TPOAb were associated with the times of suicide attempts in MDD patients comorbid anxiety symptoms. Our results demonstrate high prevalence of suicide attempts in MDD patients comorbid anxiety symptoms. Several clinical correlates, metabolic parameters, and thyroid hormones function contribute to the suicide attempts in MDD patients comorbid anxiety symptoms.
伴发焦虑的重性抑郁障碍（MDD）患者自杀未遂的相关因素仍不清楚。据我们所知，这是第一项使用大样本量研究首次检查首发、未用药的 MDD 伴发焦虑患者自杀未遂的危险因素，并包括临床相关性、代谢参数和甲状腺激素水平。共纳入 1718 例首发、未用药的 MDD 患者。采用汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和阳性和阴性综合征量表（PANSS）评估患者的症状。测量代谢参数和甲状腺激素水平。伴发焦虑症状的 MDD 患者自杀未遂的发生率为 24.28%，是不伴发焦虑症状的 MDD 患者（3.25%）的 9.51 倍。与非自杀未遂者相比，伴发焦虑症状的企图自杀的 MDD 患者 HAMD 和 HAMA 评分更高，收缩压更高，促甲状腺激素（TSH）和甲状腺过氧化物酶抗体（TPOAb）水平更高，这些与 MDD 患者伴发焦虑症状的自杀企图也有关。HAMA 评分、HAMD 评分和 TSH 的组合可以区分自杀未遂者和非自杀未遂者。此外，发病年龄、病程、BMI、TSH 和 TPOAb 与伴发焦虑症状的 MDD 患者自杀企图的次数有关。我们的结果表明，伴发焦虑症状的 MDD 患者自杀未遂的发生率较高。一些临床相关性、代谢参数和甲状腺激素功能与 MDD 患者伴发焦虑症状的自杀企图有关。
