Zhang Yaoyao, Fang Xinyu, Tang Bei, Fan Kaili, Wen Na, Zhao Ke, Xu Weiqian, Tang Wei, Chen Yi
Department of Psychiatry, Wenzhou Medical University, Wenzhou, China.
Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Front Psychiatry. 2021 Nov 11;12:769743. doi: 10.3389/fpsyt.2021.769743. eCollection 2021.
This study aimed to investigate the effect of childhood trauma, especially its specific dimensions, and clinical risk factors for suicidal ideation in patients with schizophrenia. A total of 83 inpatients with schizophrenia were enrolled and divided into two groups: with suicidal ideation ( = 33) and without suicidal ideation ( = 50). All participants were administered the Childhood Trauma Questionnaire-Short Form, the Insomnia Severity Index, the Beck Scale for Suicide Ideation, the Modified Overt Aggression Scales, the auditory hallucination rating scale, the Hamilton Rating Scale of Depression and the Positive and Negative Syndrome Scale. In our sample, 39.8% of the subjects had suicidal ideation, and 60.6% of them had suffered from childhood trauma. Patients with suicidal ideation had a higher Insomnia Severity Index score, Physical neglect score, the Childhood Trauma Questionnaire-Short Form total score (all < 0.05) compared to those without. The logistic regression analysis revealed that physical neglect in Childhood Trauma Questionnaire was significantly associated with suicidal ideation (OR = 5.46, < 0.05, 95% CI = 0.007-0.483). Further stepwise multiple linear regression identified that insomnia (β = 0.272, = 0.011) and physical neglect (β = 0.257, = 0.017) were strong risk factors for the severity of suicidal ideation in patients with schizophrenia. Mediation analysis showed that insomnia played a complete mediating role between physical neglect and suicidal ideation. Our results indicate that childhood maltreatment of physical neglect is a strong independent risk factor for suicidal ideation in schizophrenia. The risk is probably aggravated by the poor quality of sleep. Early screening and psychosocial treatment are recommended for psychotic individuals with a trauma history.
本研究旨在调查童年创伤的影响，尤其是其具体维度，以及精神分裂症患者自杀意念的临床风险因素。共纳入83例精神分裂症住院患者，分为两组：有自杀意念组（n = 33）和无自杀意念组（n = 50）。所有参与者均接受儿童创伤问卷简表、失眠严重程度指数、贝克自杀意念量表、修订的公开攻击量表、幻听评定量表、汉密尔顿抑郁评定量表和阳性与阴性症状量表的评估。在我们的样本中，39.8%的受试者有自杀意念，其中60.6%曾遭受童年创伤。与无自杀意念的患者相比，有自杀意念的患者失眠严重程度指数得分、身体忽视得分、儿童创伤问卷简表总分更高（均P < 0.05）。逻辑回归分析显示，儿童创伤问卷中的身体忽视与自杀意念显著相关（OR = 5.46，P < 0.05，95%CI = 0.007 - 0.483）。进一步的逐步多元线性回归分析确定，失眠（β = 0.272，P = 0.011）和身体忽视（β = 0.257，P = 0.017）是精神分裂症患者自杀意念严重程度的强风险因素。中介分析表明，失眠在身体忽视和自杀意念之间起完全中介作用。我们的结果表明，童年期身体忽视虐待是精神分裂症患者自杀意念的一个强大独立风险因素。睡眠质量差可能会加剧这种风险。建议对有创伤史的精神病患者进行早期筛查和心理社会治疗。
