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哮喘患者中的抑郁、自杀动机和自杀意念:一项横断面研究。

Depression, suicidal motivation and suicidal ideation among individuals with asthma: a cross-sectional study.

作者信息

Vázquez Vanessa Serva, de Lima Valmar Bião, de Mello Luane Marques, Duarte Drielle Caroline Bidu, Saback de Oliveira Thaís Dantas, Cruz Álvaro Augusto

机构信息

ProAR Foundation and Federal University of Bahia, Salvador, Brazil.

Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, Brazil.

出版信息

J Thorac Dis. 2021 Oct;13(10):6082-6094. doi: 10.21037/jtd-20-3197.

Abstract

BACKGROUND

Asthma is a chronic disease associated with risk of depression and suicidal events. The present study estimated the frequency of depression, suicidal motivation (SM) and suicidal ideation (SI) and identified clinical and psychosocial factors associated with these outcomes among individuals with asthma.

METHODS

Cross-sectional study of a non-probabilistic sample of 1,358 adults with asthma and controls without asthma. Asthma severity and asthma control were assessed by a physician according to WHO (2009) and GINA (2012) criteria. Depression, SM and SI were screened by Beck Depression Inventory (BDI). Psychosocial factors were evaluated by a Community Violence Questionnaire, a Social Support Scale, a Stress Perceived Scale and a Resilience Scale. Chi-Square Test, and logistic regression models were performed to evaluate association between variables and outcomes.

RESULTS

Among all participants, 222 (16.30%) had depression, 331 (24.40%) SM and 73 (5.40%) SI. There were 138 (12.10%) individuals with mild depression and SM, and 14 (1.20%) with mild depression and SI. After adjustment, severe asthma (SA) increased the chance of depression by 53.00% whereas mild to moderate asthma (MMA) increased by eleven-fold the likelihood of SI. Perception of low social support increased the chance of depression (OR 3.59; 95% CI, 2.44-5.28) and low resilience by (OR 2.96; 95% CI, 2.00-4.38); distress increased the odds of SM by 37.00%, and low affective support perception raised the likelihood of SI by (OR 6.82; 95% CI, 1.94-2.90).

CONCLUSIONS

Asthma, whether mild to moderate or severe, increased the chance of depression and SI. It is noteworthy that individuals with mild depression and MMA are at greater risk for SM and SI. Among the psychosocial variables, perception of low social support and low resilience were the variables associated with depression; distress impacted on SM, and the perception of low affective support raised the chance of SI.

摘要

背景

哮喘是一种与抑郁及自杀事件风险相关的慢性疾病。本研究估计了抑郁、自杀动机(SM)和自杀意念(SI)的发生率,并确定了哮喘患者中与这些结果相关的临床及社会心理因素。

方法

对1358名成年哮喘患者及无哮喘对照者的非概率样本进行横断面研究。医生根据世界卫生组织(2009年)和全球哮喘防治创议(2012年)标准评估哮喘严重程度和哮喘控制情况。通过贝克抑郁量表(BDI)筛查抑郁、SM和SI。通过社区暴力问卷、社会支持量表、压力感知量表和复原力量表评估社会心理因素。采用卡方检验和逻辑回归模型评估变量与结果之间的关联。

结果

在所有参与者中,222人(16.30%)患有抑郁症,331人(24.40%)有SM,73人(5.40%)有SI。有138人(12.10%)患有轻度抑郁症和SM,14人(1.20%)患有轻度抑郁症和SI。调整后,重度哮喘(SA)使抑郁几率增加53.00%,而轻度至中度哮喘(MMA)使SI可能性增加11倍。感知到低社会支持会增加抑郁几率(比值比3.59;95%置信区间,2.44 - 5.28),低复原力会增加抑郁几率(比值比2.96;95%置信区间,2.00 - 4.38);痛苦使SM几率增加37.00%,低情感支持感知使SI可能性增加(比值比6.82;95%置信区间,1.94 - 2.90)。

结论

哮喘,无论轻度至中度还是重度,都会增加抑郁和SI的几率。值得注意的是,患有轻度抑郁症和MMA的个体发生SM和SI的风险更高。在社会心理变量中,低社会支持感知和低复原力是与抑郁相关的变量;痛苦影响SM,低情感支持感知增加SI的几率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6b2/8575806/2834fb448be6/jtd-13-10-6082-f1.jpg

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